How to treat prostate cancer patients who are waiting for treatment to progress

For patients who choose to wait for treatment and see if their disease progresses, there are many ways to treat prostate cancer, which should be selected based on the patient's specific circumstances. If the patient meets the conditions, curative treatment should be considered first.

1. Radical prostatectomy

For patients who are waiting for progression, radical surgery can be considered if the tumor is confined to the prostate, the patient is in good physical condition, and the life expectancy is greater than 10 years.

2. Brachytherapy

For patients who are awaiting progression while on watch, if the tumor is confined to the prostate and the life expectancy is less than 10 years, brachytherapy can be considered for those who are more than 5 years.

3. External beam radiation therapy

For patients who are waiting for progression, patients with locally advanced tumors (T1-4N0-1M0) but no distant metastasis who cannot be treated with radical treatment can be given external beam radiotherapy.

4. Endocrine therapy

Endocrine therapy can be used for patients who are waiting for disease progression, have local tumor progression or no local tumor progression, have distant metastasis or no distant metastasis, are too old to meet the conditions for radical treatment, or are unwilling to receive radical treatment. For patients who are waiting for disease progression, intermittent endocrine therapy or simple castration may be a better choice.