Your doctor will explain the benefits and possible disadvantages and side effects of the treatments to you. You can then decide which is best for your particular situation. The benefits and disadvantages of the treatments for early prostate cancer are outlined in the following pages. Before you have any treatment it is important that you are fully aware of them.

It is not possible for doctors to predict accurately who is going to be affected by the side effects of each treatment. So, you need to be given full information about the risks beforehand and have plenty of opportunity to discuss them. Remember, there are often choices to be made about which treatment you should have, or even whether to have treatment. You can take as large or small a part in those choices as you wish.

Most early-stage prostate cancers may be very slow-growing and may never cause any symptoms. For this reason, some men and their specialists decide to wait and see whether the cancer is getting bigger (progressing) before starting any treatment. The active surveillance approach involves regular check-ups with PSA tests, rectal examination of the prostate and possibly repeat biopsies.

Benefits: Many men who choose active surveillance will avoid the complications of surgery, radiotherapy, or hormonal therapy.

Risks: Some men find it difficult just to wait and see if their cancer progresses before starting any therapy. Some men will need surgery, radiotherapy or hormonal therapy if their cancer shows signs of developing.

A major surgical operation to remove the whole prostate gland.

Benefits: Removing the whole prostate gland may stop an early cancer from spreading and may result in a cure. Radical prostatectomy appears to prolong life for some men with more fast growing cancer, but for men with small, slow-growing cancers the benefits are unclear, and probably only apply to younger men. In two out of five men, the cancer cells are not fully removed, and therefore the operation may not result in a cure.

Risks: One in 200 men over 65, and one in 1000 men under 65, may die from problems caused by surgery; up to 20 will develop slight leaking of urine; around 5 will have incontinence of urine; and about 70 will have problems getting an erection.

High-energy rays are used to destroy cancer cells.

Benefits: Radiotherapy may lead to a cure in early prostate cancer, but as with prostatectomy, the benefits in small, slow-growing cancers are uncertain. A complete course takes up to seven weeks. Giving hormone therapy before and during the radiotherapy may improve the results.

Risks: For every 100 men who have external beam radiotherapy: up to 30 will develop occasional bleeding from the rectum (back passage); about 10 may have bleeding, a change in bowel habit and some discomfort; and up to 70 will develop erection problems (though this depends on age). Rarely, some men may have leakage of urine or incontinence of urine.

A new type of radiotherapy, which uses radioactive 'seeds' inserted into the prostate.

Benefits: Same as for external beam therapy. A simpler procedure than external beam radiotherapy, as it usually only involves one planning session and one treatment session (under general anaesthetic) during a stay in hospital of one or two days.

Risks: Side effects to the bladder, such as inflammation (cystitis) may be more severe than external beam radiotherapy, but bowel problems (diarrhoea) and impotence are expected to be less common. Scar tissue may cause gradual narrowing of the urethra which may need to be treated.

Lowers the levels of testosterone in the body, by removing the testes or using tablets or injections. Hormonal therapy may be used on its own or given with radiotherapy treatment.

Benefits: Can slow or stop the growth of cancer cells for many years. Does not involve surgery or radiation so there is little risk of bowel or bladder problems.

Risks: It will not get rid of all the cancer cells if it is the only treatment given and can cause a range of side effects that include breast swelling and hot flushes, impotence and lowered sex drive.