The majority of prostate cancers are curable, particularly those that haven’t spread to distant parts of your body at the time of diagnosis.

Prostate cancer has one of the highest survival rates of any cancer and is often curable if found at an early stage. Doctors typically consider you cured if there are no signs of your cancer for at least 5 years.

Usually, the treatment goal for prostate cancer is to try to cure the cancer and keep it from coming back. For some men with advanced cancer, the goal of treatment is to alleviate symptoms and improve quality of life.

In this article, we review the chances of curing prostate cancer and what your treatment options are.

Language matters

In this article, we talk about prostate cancer in people assigned male at birth.

It’s important to note that not everyone assigned male at birth identifies with the label “male.” However, at times we use “male” or “men” to reflect the language in a study or statistic or to make sure people can find this article with the terms they search.

When possible, we aim to be inclusive and create content that reflects the diversity of our readers.

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Prostate cancer treatment is usually most effective when prostate cancer is limited to the early stages.

Various staging systems have been developed to describe prostate cancer. The most commonly used system is called the American Joint Committee on Cancer (AJCC) TNM system. It divides cancer from stage 1 to stage 4B depending on:

  • the extent of the cancer
  • whether it has spread to nearby lymph nodes
  • whether it has spread to other parts of your body
  • your prostate-specific antigen (PSA) levels
  • your grade group, a measure of how quickly the cancer is predicted to spread.

Stage 1 prostate cancer is the easiest to treat and is almost always curable. Stage 4B cancer is the hardest to treat, but about a third of people still live more than 5 years.

The National Cancer Institute uses a different staging system. They classify prostate cancer as localized, regional, or distant. They list the following survival rates from 2012 to 2018:

StageApproximate AJCC equivalent5-year relative survival rate
LocalizedStage 1 to 3AAbout 100.0%
RegionalStage 3B to 4AAbout 100.0%
DistantStage 4B32.3%

Doctors may recommend palliative treatment if you have stage 4B prostate cancer and if other treatment options haven’t been effective.

Learn more about prostate cancer stages.

Questions to ask your doctor about treatment

Undergoing cancer treatment can be stressful, but preparing a list of questions to ask a doctor can help you better understand the process and make it seem less overwhelming. Here are some questions you may want to ask.

  • What are my treatment options?
  • What are the pros and cons of each treatment?
  • How long will I have to undergo treatment?
  • How much will my treatment cost and how much is covered under insurance?
  • Is the goal of my treatment to cure the cancer or to manage symptoms?
  • Am I eligible for any clinical trials?
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Doctors choose from eight standard treatments for prostate cancer. Researchers are also examining the effectiveness of newer treatments such as cryotherapy and high-intensity-focused ultrasound therapy.

Watchful waiting and active surveillance

Watchful waiting and active surveillance both involve waiting to see how your cancer changes over time.

Active surveillance involves monitoring the cancer with a PSA blood test about every 6 months and a digital rectal exam about once a year. You may also have imaging and prostate biopsies taken every 1 to 3 years. If your test results change, your doctor may recommend a more aggressive treatment to try to cure the cancer.

Watchful waiting involves fewer follow-up tests. If you develop symptoms, your doctor may recommend treatments to improve your quality of life.

Benefits and risks of watchful waiting and active surveillance

These two treatments avoid the potential risks of more aggressive prostate cancer treatments but also come with the risk of the cancer progressing. The goal of watchful waiting isn’t to cure the cancer but to target symptoms as they develop.

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Surgery may be an option if the cancer is contained in your prostate. The most common type of surgery is called radical prostatectomy. During this procedure, your prostate, surrounding tissue, and seminal vesicles are all removed. Nearby lymph nodes may also be removed.

Benefits and risks of prostate cancer surgery

Surgery has the possibility of curing your cancer, but it can also cause side effects. Potential side effects can include:

Learn more about prostate cancer surgery.

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Radiation therapy

Radiation therapy uses high-energy waves to kill cancer cells. One of three types may be administered:

  • External radiation therapy: This type involves using an external machine to expose your prostate to radiation.
  • Brachytherapy: This type involves placing radioactive material inside your body to destroy the cancer.
  • Radiopharmaceutical therapy: This type is used to treat cancer that has spread to your bone. It involves injecting radioactive radium-223 into your bloodstream.

Benefits and risks of prostate cancer radiation therapy

Radiation therapy can potentially cure prostate cancer by itself or combined with other treatments. Brachytherapy usually only requires one treatment session.

Men who receive radiation therapy have an increased risk of gastrointestinal or bladder cancer. It can also cause side effects such as erectile dysfunction or urinary problems.

Learn more about prostate cancer radiation therapy

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Hormone therapy

Hormone therapy involves decreasing levels of male sex hormones that allow prostate cancer cells to grow. This may be achieved with medications or with surgery to remove the testicles. It’s a standard treatment option for stage 3 or 4 prostate cancer.

Benefits and risks of hormone therapy

Hormone therapy can cause cancer cells to grow slower or die, but it can also cause side effects such as:

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Chemotherapy involves taking medications that contain chemicals that cause cancer cells to die. These chemicals also damage healthy cells in your body that divide quickly. It may be combined with hormone therapy to treat stage 4 prostate cancer.

Benefits and risks of chemotherapy

Chemotherapy can potentially shrink prostate tumors, but it can also damage healthy cells in your body. It may cause side effects such as:

Learn more about chemotherapy for prostate cancer.

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Targeted therapy

Targeted therapy involves taking drugs that specifically target cancer cells. It tends to cause less damage to healthy cells than chemotherapy.

Benefits and risks of targeted therapy

Targeted therapy is a treatment option for late stage prostate cancer that doesn’t respond to other treatments. However, it can still cause side effects such as:

  • nausea
  • vomiting
  • diarrhea
  • fatigue
  • appetite loss
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Immunotherapy involves taking drugs to stimulate your immune system to attack cancer cells.

Benefits and risks of immunotherapy

Immunotherapy may cure prostate cancer when other treatments don’t work. Side effects include:

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Bisphosphonate therapy

Bisphosphonates are medications that reduce the weakening or destruction of the bone that can occur when cancer spreads to your bone.

Benefits and risks of targeted therapy

Bisphosphonates can’t cure prostate cancer, but they may help you prevent bone loss. Side effects include:

  • bone or joint pain
  • flu-like symptoms
  • kidney problems
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The outlook for people with prostate cancer is generally very good. It has one of the highest survival rates of any cancer. The 5-year relative survival rate for all stages combined is nearly 97%. (Relative survival rates compare the survival rates of people who have a disease with those who don’t have that disease).

Prostate cancer treatment can be stressful and negatively impact your quality of life. Many men develop side effects after treatment such as urinary incontinence or erectile dysfunction. A doctor can help you build a treatment plan for any side effects you may experience.

Can prostate cancer be cured forever or is it likely to return?

The majority of prostate cancers are curable. Biochemical recurrence of prostate cancer occurs in about 25% of people who receive a radical prostatectomy and up to 45% of people who receive external radiotherapy.

Biochemical reoccurrence means that your PSA levels increase to a threshold that suggests that cancer has returned. If the cancer returns, your doctor will likely recommend another treatment such as hormone therapy.

At what stage is prostate cancer not curable?

Typically, stage 4B prostate cancer isn’t considered to be curable. But you should talk with a doctor about how your body is responding to treatment and your individual outlook.

How long can you live with stage 4 prostate cancer?

About one third of people who received a diagnosis of stage 4 prostate cancer survive longer than 5 years.

How do I know what treatment option is best for me?

Deciding on a prostate cancer treatment can be difficult. Your healthcare team can help you weigh the pros and cons of each option. You may also find it helpful to talk with somebody who has gone through prostate cancer treatment to understand their experience.

The American Cancer Society offers a 24/7 helpline where you can contact a cancer specialist who can help you understand your options.

Prostate cancer is almost always curable if it hasn’t spread to distant body parts. About a third of prostate cancers that have spread to distant organs are still curable.

Your healthcare team can help you understand which treatment options give you the best chance of survival or can help you manage your symptoms.