/ Updated August 4th, 2025

Empowering Men To Make Treatment Decisions Based On Their Priorities

: Dr. James Taylor Medical Source: Dr. James Ryan Mark
Fox Chase Cancer Center Written by: Dr. Kaique Filardi
University of São Paulo

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Making Treatment Decisions: It's Your Choice

As the patient, you should have an active role in making prostate cancer treatment decisions — and experts recommend carefully weighing the risks vs. benefits of each approach with your medical team.
Some treatments may offer a better chance of cancer control but may be linked to difficult side effects.
Open and honest conversations with your team can help you understand how your quality of life will be impacted with each option.
Contrary to popular belief, patients can also play a role in how they tolerate treatment. Sometimes, making lifestyle changes like adjusting your diet or exercise routine can have a big impact.

When you are facing prostate cancer and weighing treatment options, it might feel like the decisions are happening for you. Yet as the patient, you should have an active role in making those treatment decisions — and experts recommend carefully weighing the risks vs. benefits of each approach with your medical team.

“I think it’s important for men to take account of what’s important to them. There are a lot of options for treatments — every treatment option has its pros and its cons,” Dr. James Ryan Mark, a urologic oncologist at Fox Chase Cancer Center in Philadelphia, tells SurvivorNet.

“While some treatment may be better in terms of giving better control of the prostate cancer, they may not be what you want in terms of side effects … In certain cases, the differences between the treatment options can be relatively minor,” he adds.

A common example in prostate cancer is adding androgen‑deprivation therapy (ADT) shots, which lower testosterone, to radiation. Although this combination can enhance cancer control, especially in men with higher‑risk disease, it can speed up the loss of muscle and energy.

For an older adult, muscle loss is highly associated with poor outcomes. Therefore, the goal isn’t just “more treatment” or “less treatment,” it’s the right treatment for you.

This is why it’s important to make your doctor aware of your current thoughts, goals, and how each might impact your treatment. In addition to that, having your loved ones support your decisions can potentially facilitate how you approach the next step.

In this context, ask yourself: Is your top goal maximum cancer control, even if you feel weaker for a time, or is preserving strength and independence the deciding factor?

When your team knows your target, they can design a treatment plan more catered to it.

Taking An Active Role In Treatment

Contrary to what most patients believe, you can take steps each day to help mitigate the effects of cancer treatment — no matter which treatment path you take.

For example, if you’re worried about losing muscle and/or metabolic changes, set goals to increase your gym and exercise activities. Aim for enough protein each day to support muscle (your clinician or dietitian can give you a personal number), build your plate around vegetables, whole grains, and lean proteins, and plan sleep like a medicine. If you have faced mood changes due to treatment, try setting up appointments with a therapist or joining a support group.

“It’s always good to ask what the benefit of each aspect of the treatment is and what can be given in a different way,” Dr. Mark adds. If a treatment approach is causing too many side effects, for example, you medical team may be able to reduce your dose or tweak the overall plan.