Specialists often divide localised prostate cancers into risk groups to describe the behaviour of the cancer and how likely it is to grow.

To work out your risk group, your specialist team will look at your PSA level, your Gleason score and the stage of your cancer.

This can be used to help decide what treatment options are suitable for you.

Low risk
Your cancer may be described as low risk if:

• Your PSA level is 10ng/ml or less, and
• Your Gleason score is 6 or less, and
• The stage of your cancer is T1 to T2a

Intermediate risk
Your cancer may be described as intermediate risk if:

• Your PSA level is between 10 and 20ng/ml, or
• Your Gleason score is 7, or
• The stage of your cancer is T2b or T2c

High risk
Your cancer may be described as high risk if:

• Your PSA level is 20 ng/ml or higher, or
• Your Gleason score is 8 or higher

The treatment options for localised prostate cancer are:

• Watchful waiting
• Active surveillance
• Radical prostatectomy
• External beam radiotherapy
• Brachytherapy

Less well established and less common treatment options are:

• High intensity focused ultrasound (HIFU)
• Cryotherapy

HIFU and cryotherapy are more commonly used to treat prostate cancer that has started to grow again after radiotherapy or may be available as part of a clinical trial.

Your choice of treatment will depend on your personal preferences and a number of different factors.

Read more about the different treatment options for prostate cancer.

There are several treatment options available for localised prostate cancer.

Choosing a treatment is an important decision and you should make sure you have all the information you need before deciding. In most cases there is no urgency and you may want to take some time to think things through before coming to a decision. Read more.

Your choice of treatment may depend on many factors including:

• How the cancer is behaving and whether your cancer is low, intermediate or high risk
• Your general health and age. This could include, for example, any symptoms you have such as urinary problems, or other medical conditions you have, such as heart disease
• The possible side effects of each treatment
• The advantages and disadvantages of the treatment, including practical aspects of treatment, such as how often you would need to go to hospital, or how far away your nearest treatment centre is
• Your general views about different treatments, for example some men prefer to have their prostate gland removed, while others may not like the idea of surgery

Many of the treatments options for localised prostate cancer involve starting the treatment straight away. However, you also have the option to have your cancer monitored.

Many prostate cancers grow very slowly and may never cause harm within a man's lifetime. In these cases, treatment itself may cause side effects which, for some men, may be worse than any problems that may be caused by the cancer. However, it is not always possible to tell how quickly the cancer may grow.

There are two different options which aim to avoid active treatment unless it becomes necessary later on. These are called active surveillance and watchful waiting.

Some men who would not wish to deal with the possible side effects of treatment may choose active surveillance. However, other men are not comfortable with monitoring the condition and prefer active treatment.

Sometimes older men, whose cancer may grow slowly and might not cause a problem in their lifetime, or men who may not benefit from active treatments, may choose to monitor their cancer with watchful waiting.

To help make sure that your treatment has been successful, your specialist team will monitor your response to the treatment closely for the first few months after treatment. You will then continue to have yearly PSA tests.

For many men with localised prostate cancer their treatment will get rid of the cancer, but in some cases a few cancer cells may be left after the treatment and you may need more treatment. Read about recurrent prostate cancer.