You could ask about focal therapies. They treat just the cancer and not the whole prostate. It depends if your cancer is focal and where it is as to how suitable you might be. You need to be referred to a focal therapy centre to find out if you're suitable.
Pros:
Generally fewer side effects. Depending where the cancer is, you might preserve erectile function, continence, and even some semen.
Cons:
Might not treat all the cancer (usually only one or two main lesions are treated), leaving you on active surveillance for what's left.
More likely to recur. Prostate cancer often isn't focal, springing up in many places in the prostate eventually. Can sometimes be treated with focal again, but also radiotherapy or prostatectomy are likely to be salvage options too. You might end up worse off after either of these salvage treatments than if you'd had them in the first place though.
There might be a slightly higher possibility of it recurring and eventually going metastatic than if you have a whole-prostate treatment at the outset.
Not many centres do focal therapies, and they're mostly in the South-East, so it might involve some travel.
A pre-existing reduction in erectile function doesn't help with outcomes of erectile function - it's not going to improve and often gets at least a little worse. Have you have that investigated and is the cause known?
EDIT: Just to add, preserving some semen is not the same as remaining fertile, if that's the reason for concern. Semen contains lots of different components, and although you might still ejaculate something, which if you're lucky still looks like semen, it doesn't mean all the components will still be present, so it is much less likely to be viable for fertility even so.
Edited by member 15 Apr 2024 at 16:27
| Reason: Not specified