Shared Decision Making

Treatment Options for Low-Risk (Slow-Growing) Prostate Cancer

This decision aid is for people with prostate cancer who are at low risk of cancer spreading. Low risk is Stage T1 or T2a, Gleason score 6 or lower, and prostate-specific antigen (PSA) level lower than 10 ng/mL.

About Prostate Cancer: The prostate is a gland below the bladder that helps make semen. Cancer is when cells grow in abnormal ways.

Patient Questions

What does the option involve?
Monitor With Tests
You will have tests a few times a year. They may include blood tests, rectal exams, and scans. A healthcare professional may also take a sample (biopsy) from your prostate every few years. You may start treatment based on what the tests show.
Radiation Treatment
A machine will treat your prostate with high-energy x-rays. You will do this 5 days a week for several weeks. Each session takes up to 30 minutes.
Radiation Implants
A healthcare professional will put grain-size pieces of metal (implants) into your prostate. These pieces give off radiation for months. The implants may be removed or may stay inside your body.
Surgery
A surgeon will remove your prostate. The surgeon may use a robot to guide the surgery. You may stay in the hospital for 1 to 2 days. You may have a tube (catheter) put in your penis to drain pee for 1 to 2 weeks.
What are my chances of surviving prostate cancer for 5 years?
Monitor With Tests
Nearly all people (almost 100%) survive prostate cancer at least 5 years after finding the cancer.
Radiation Treatment
Nearly all people (almost 100%) survive prostate cancer at least 5 years after finding the cancer.
Radiation Implants
Nearly all people (almost 100%) survive prostate cancer at least 5 years after finding the cancer.
Surgery
Nearly all people (almost 100%) survive prostate cancer at least 5 years after finding the cancer.
What are the short-term side effects?
Monitor With Tests
Short-term side effects may include worrying about your cancer spreading.
Radiation Treatment
Short-term side effects may include:
  • Pain or blood while peeing.
  • Not being able to pee.
  • Diarrhea or rectal pain.
Radiation Implants
Short-term side effects may include:
  • Leaking pee.
  • Not being able to pee.
Surgery
Short-term side effects may include:
  • Bleeding.
  • Blood clots.
  • Infection.
What are the long-term side effects?
Monitor With Tests
Long-term side effects may include worrying about your cancer spreading.
Radiation Treatment
Long-term side effects may include:
  • Sexual problems.
  • Higher risk for certain types of cancer.
Radiation Implants
Long-term side effects may include sexual problems.
Surgery
Long-term side effects may include:
  • Sexual problems.
  • Leaking pee.
  • Trouble peeing.
When will I return to my usual activities?
Monitor With Tests
Most people can continue their usual activities.
Radiation Treatment
Most people can continue their usual activities.
Radiation Implants
Most people return to their usual activities within a week. People may need to use condoms and avoid children and pregnant people for several months. The implants may pass radiation to others.
Surgery
Most people return to usual activities in 4 to 6 weeks.
Definitions

Prostate biopsy: A healthcare professional will use a needle to take samples of the prostate.

Cancer Stage T1 or T2a: It is when the cancer has not spread outside of the prostate. The cancer is growing slowly.

Gleason score: This measure tells how likely the cancer is to spread.

PSA (prostate-specific antigen): PSA is a protein made by the prostate. The PSA level is the amount of PSA in your blood.

References
  1. American Cancer Society. Radiation Therapy for Prostate Cancer. American Cancer Society website. Updated Mar 28, 2025. Accessed Jul 2, 2025. https://www.cancer.org/cancer/types/prostate-cancer/treating/radiation-therapy.html
  2. American Cancer Society. Surgery for Prostate Cancer. American Cancer Society website. Updated Nov 22, 2023. Accessed Mar 14, 2025. https://www.cancer.org/cancer/types/prostate-cancer/treating/surgery.html
  3. Cleveland Clinic. Brachytherapy. Cleveland Clinic website. Updated Nov 18, 2024. Accessed Mar 24, 2025. https://my.clevelandclinic.org/health/treatments/16500-brachytherapy
  4. Cleveland Clinic. External Beam Radiation Therapy (EBRT). Cleveland Clinic website. Updated Jun 30, 2025. Accessed Jul 16, 2025. https://my.clevelandclinic.org/health/treatments/24008-external-beam-radiation-therapy-ebrt
  5. Cleveland Clinic. Prostatectomy. Cleveland Clinic website. Updated Oct 9, 2022. Accessed Mar 7, 2025. https://my.clevelandclinic.org/health/treatments/24294-prostatectomy
  6. DynaMedex. Prostate Cancer. DynaMedex website. Updated Jun 12, 2025. Accessed Jul 2, 2025. https://www.dynamedex.com/condition/prostate-cancer
  7. DynaMedex: Management of Localized or Locally Advanced Prostate Cancer. DynaMedex website. Updated Jun 26, 2025. Accessed Jul 2, 2025. https://www.dynamedex.com/management/management-of-localized-or-locally-advanced-prostate-cancer
  8. Hamdy FC, Donovan JL, Lane JA, Metcalfe C, Davis M, Turner EL, Martin RM, Young GJ, Walsh EI, Bryant RJ, Bollina P, Doble A, Doherty A, Gillatt D, Gnanapragasam V, Hughes O, Kockelbergh R, Kynaston H, Paul A, Paez E, Powell P, Rosario DJ, Rowe E, Mason M, Catto JWF, Peters TJ, Oxley J, Williams NJ, Staffurth J, Neal DE, ProtecT Study Group. Fifteen-Year Outcomes after Monitoring, Surgery, or Radiotherapy for Prostate Cancer. N Engl J Med. 2023 Apr 27;388(17):1547-1558 full-text
  9. Johns Hopkins Medicine. Brachytherapy. Johns Hopkins Medicine website. Accessed Mar 7, 2025. https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/brachytherapy
  10. Johns Hopkins Medicine. Prostatectomy: What to Expect During Surgery and Recovery. Johns Hopkins Medicine website. Accessed Mar 7, 2025. https://www.hopkinsmedicine.org/health/conditions-and-diseases/prostate-cancer/prostatectomy-what-to-expect-during-surgery-and-recovery
  11. Mayo Clinic. Active surveillance for prostate cancer. Mayo Clinic website. Updated Nov 15, 2023. Accessed Mar 13, 2025. https://www.mayoclinic.org/tests-procedures/active-surveillance-for-prostate-cancer/about/pac-20384946
  12. Mayo Clinic. Prostate biopsy. Mayo Clinic website. Updated Apr 30, 2025. Accessed Jul 14, 2025. https://www.mayoclinic.org/tests-procedures/prostate-biopsy/about/pac-20384734
  13. Mayo Clinic. Prostatectomy. Mayo Clinic website. Updated Sep 7, 2024. Accessed Feb 13, 2025. https://www.mayoclinic.org/tests-procedures/prostatectomy/about/pac-20385198
  14. National Cancer Institute Hormone Therapy for Prostate Cancer. National Cancer Institute website. Updated Oct 4, 2024. Accessed Feb 17, 2025. https://www.cancer.gov/types/prostate/prostate-hormone-therapy-fact-sheet
  15. National Cancer Institute. Surveillance, Epidemiology, and End Results Program. SEER*Explorer. National Cancer Institute website. Updated Jul 2, 2025. Accessed Jul 16, 2025. https://seer.cancer.gov/statistics-network/explorer/application.html?site=1&data_type=1&graph_type=2&compareBy=sex&chk_sex_3=3&chk_sex_2=2&rate_type=2
  16. University of California San Francisco Health. FAQ: Radiation Therapy for Prostate Cancer. University of California San Francisco Health website. Accessed Feb 14, 2025. https://www.ucsfhealth.org/education/faq-radiation-therapy-for-prostate-cancer#
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The EBSCO Health Option Grid ™ decision aids are not intended to be medical advice, diagnosis or treatment and are intended to provide information to help people engage in shared decision making with health professionals.
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