Localized prostate cancer has multiple treatment options available, and each one has its own list of benefits and risks. Patients and their partners need to discuss these benefits and risks with their physicians in order to make an informed decision about their treatment. Some factors that impact the treatments offered to an individual patient include quality of life issues, the patient’s lifestyle, and PSA. Current treatments available for localized prostate cancer include the following:

  • High Intensity Focused Ultrasound (HIFU)
  • Hormone Therapy
  • Radiation Therapy
  • Radical Prostatectomy
  • Cryotherapy

Another option, known as watchful waiting, involves doing nothing until the cancer shows signs of beginning to spread. This, while technically not a treatment at all, allows patients to enjoy their full quality of life for as long as possible before pursuing treatment. Patients will be regularly monitored for signs of their cancer spreading if they choose watchful waiting.


The Sonablate 500 has not yet been approved for use in the United States as a prostate cancer treatment device. It is still in the investigational stages and clinical trials in the US. All information below is for general informational purposes, and patients need to know that the FDA has not yet determined whether the Sonablate 500 is efficient and safe as a prostate cancer treatment device. Always seek the advice of a medical professional when making decisions about your health and prostate cancer treatment.

High Intensity Focused Ultrasound

High Intensity Focused Ultrasound, or HIFU, is a treatment that uses ultrasound waves to heat and destroy the prostate gland and the cancer it contains. A transrectal probe is used to send ultrasound waves into the prostate gland. This probe also captures images of the prostate gland to guide the treatment. During HIFU treatment with the Sonablate 500, the entire prostate gland is destroyed, thus eliminating the cancer. Most patients are able to undergo the treatment in one to four hours on an outpatient basis. Patients typically are able to walk within hours of HIFU treatment with the Sonablate, and most will wear a catheter for up to four weeks. Potential side effects include discomfort when urinating, urinary discharge, urgency, and frequency. Potential complications found in international studies include retention, urinary stricture, incontinence, rectal fistula, and erectile dysfunction.

Hormone Therapy

Hormone therapy for prostate cancer works to lower testosterone levels in the patient’s body. Testosterone is believed to fuel the growth of prostate cancers, so lowering these levels causes the cancer to grow more slowly, and some will even shrink. Hormone therapy does not cure prostate cancer, but it can lengthen a patient’s life. Potential quality of life issues include weight gain, anemia, osteoporosis, depression, loss of muscle mass, fatigue, and decreased mental acuity.

Radiation Therapy

Radiation therapy involves two treatment options. External Beam Radiation Therapy, or EBRT, involves sending radiation into the prostate gland from outside of the body. This is recommended for prostate volumes of less than 60 grams. Brachytherapy involves placing tiny radioactive seeds into the prostate gland, where they gradually release their radioactive properties to destroy the gland.

Radical Prostatectomy

A radical prostatectomy refers to the surgical removal of the prostate gland and some of the surrounding tissue. This is often used for cancer that has just begun to spread outside of the prostate. It can be done laparoscopically or through an open surgical procedure. This is the oldest treatment method for prostate cancer and takes between two and eight hours, depending on the type of surgery chosen. Patients will need to stay in the hospital and must receive general anesthesia for this surgery. A catheter is required after surgery to allow the area to heal. Potential risks include blood loss, incontinence, and impotence, in addition to the risks from surgery.


Cryotherapy represents a minimally invasive prostate cancer treatment option. It works by freezing the prostate gland using cold gasses infused into the gland through needles. Ultrasound imagery guides the treatment to ensure that the tissue is destroyed completely. It can be done under spinal or general anesthesia. Other names for this procedure include cryoablation and cryosurgery. Potential risks include erectile dysfunction, rectal fistula, swelling, and incontinence.