Surgery: This is the most common treatment.
Radical prostatectomy is still the most common surgery. This involves removal of the whole prostate, the seminal vesicals and lymph nodes that drain the area.
Laparoscopic surgery does the prostatectomy through smaller incisions.
Nerve sparing prostatectomy is a more time consuming procedure. If the cancer is small and far away from the two bundles of nerves that control the prostate and erections, the surgeon can work around the nerves. There is less danger of impotence following surgery. The danger is that some cancer cells may be left behind so the operation does not give the best chance of cure.
Radiation: radiotherapy.
Traditionally this has been done with equipment that focuses generally on the prostate region. The head of the machine travels in an arc with the beam pointing at the prostate. As it moves through the arc, only the prostate is constantly in the line of the beam. The prostate receives the full dose, the surrounding tissue less.
The tecniques are improving every day. Recent improvements are CRT, conformal radiotherapy where the radiation beam matches the shape of the prostate and IMRT, intensity modulated radiotherapy where the surrounding tissues receive less radiation.
