NCCN Guidelines for Patients® | Prostate Cancer - page 46

46
NCCN Guidelines for Patients
®
: Prostate Cancer
Version 1.2014
Part 5: Initial treatment by risk group
LDR brachytherapy alone. They can also be treated with
EBRT to the prostate and maybe the seminal vesicles but
not to the pelvic lymph nodes.
The third option is to have a radical prostatectomy. If you
choose a prostatectomy, you may also have a PLND if
your risk is 2% or higher for having cancer in the pelvic
lymph nodes. Your doctor will determine your risk using a
nomogram, which was described in Part 3.
5.2 Low risk
Primary treatment
Treatment options
Expected
years to live
This chart lists the treatment options for men at low risk
of recurrence. The criteria for low risk include T1 and T2a
tumors. Treatment options are based on how many years
a man is expected to live.
If you’re likely to live less than 10 years, starting
observation after diagnosis is recommended since the
cancer may never cause any problems. Observation
consists of testing on a regular basis so that supportive
Observation
<10 years
≥10 years Radiation therapy
• EBRT, or
• LDR brachytherapy
Surgical treatment
• Radical prostatectomy, or
• Radical prostatectomy + PLND if ≥2% risk of cancer in lymph nodes
Active surveillance
• PSA no more often than every 6 months,
• DRE no more often than every 12 months, and
• Prostate biopsy no more often than every 12 months
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