Surgery is a locoregional treatment for cancers. The proposed procedure is a total prostatectomy, also known as radical prostatectomy. It is the surgical removal of the prostate gland and it typically involves a hospital stay of several days.

IIt aims to remove the entire prostate and the seminal vesicles*. In some cases, the neighbouring lymph nodes* are also removed; this is called lymph node dissection. This operation is performed by a urologist through open, laparoscopic, or robot-assisted surgery.

The two most common side effects of this surgery are loss of bladder control (incontinence) and the inability to maintain an erection (impotence)

Brachytherapy is a local treatment for cancers. Brachytherapy of the prostate involves placing radioactive sources inside the prostate. These radioactive elements emit radiation that destroys the cancer cells.

There is only limited radiation to surrounding tissues such as the urethra, bladder and rectum. The dose of radiation decreases very quickly in a few millimetres, which limits the undesirable effects* on the neighbouring healthy tissues.

The seeds are usually permanently implanted, and the radiation dissipates in several months.

Radiotherapy is a locoregional treatment for cancers. It uses ionising radiation to destroy cancer cells by preventing them from multiplying. It consists of precisely directing this radiation (also called rays or radiations) on the area to be treated, while preserving as much as possible the healthy tissues and the neighbouring organs, known as organs at risk (in particular the bladder and the last segment of the digestive system: rectum and anal canal).

This radiation is produced by a device called a linear accelerator.

The treatment is divided into about 20 to 40 sessions spread over 4 to 8 weeks,4,5 days a week. During the sessions, which last about 20 minutes, the patient remains motionless on the treatment table and the machine delivers the rays without causing any pain to the patient.

Side effects may include problems with urination and impotence, as well as injury to the bowel.

When an early low-risk tumour is localized and not causing symptoms, a surveillance technique may be recommended.

Since many prostate cancers are slow growing, a physician may recommend close observation for a period of time without any active treatment, during which the tumor’s progress is carefully monitored through PSA controls. A new biopsy can be repeated to confirm that the low-risk tumor is not progressing to a higher-risk group. The aim is to delay treatment and the associated side effects* until it becomes necessary

Hormones are administered to lower the levels of testosterone (male hormone) or to block testosterone receptors which slows the growth of cancerous cells over a period of time. Under certain circumstances, hormones may be used in combination with brachytherapy to shrink the prostate and the tumour.

Prostate cancer is a so-called hormone-sensitive cancer, i.e., its development is stimulated by male hormones*: androgens and more particularly testosterone, which is responsible for male characteristics. Hormone therapy consists of preventing the stimulating action of testosterone on the cancer cells to stop the development of the cancer.