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Prostate cancer patients have more treatment options than ever before

Washington University School of Medicine

According to the American Cancer Society (ACS), deaths from prostate cancer declined by about 50 percent from the mid-1990s to the mid-2010s. While that sharp decline has since leveled off, prostate cancer deaths are continuing to slowly decrease each year thanks to earlier detection, better access to care and improved prostate cancer treatment options. And as new therapies and more advanced imaging techniques continue to emerge, prostate cancer patients have better and better chances at a positive outcome.

Do you have concerns about your prostate cancer treatment options?

As a prostate cancer patient, being aware of your treatment options is a key part of your journey. Maybe you have yet to speak with a doctor about your treatment, or maybe you’re not sure about the treatment your doctor has recommended and you want to get a second opinion. In either case, you likely have questions about the best course of treatment for you.

Here are some common questions that prostate cancer patients have for their doctors:

  • Do I need treatment?
  • What are my treatment options?
  • What type of treatment plan do you recommend? Why?
  • What is the goal of each treatment?
  • Who will be a part of my treatment team? What does each member do?
  • Who will be in charge of my overall treatment?
  • Should I take part in a clinical trial?
  • How will this treatment impact my daily life?
  • Will this treatment make it hard to urinate?
  • How will this treatment affect my ability to have sex?
  • Will I be able to have children after this treatment?
  • I’m concerned about the cost of my care. Are there financial aid services that can help?
  • What support services are available to me and my loved ones?

How Siteman recommends treatment

At Siteman, our specialists work to make sure that prostate cancer patients are aware of all their treatment options. After going over these treatment options with your doctor, you will receive a personalized treatment plan that will be overseen by a team of multidisciplinary experts. This wide-ranging expertise means that your prostate cancer will be attacked from all angles.

Personalized prostate cancer treatment plans depend on several factors. These include:

  • Specific diagnosis and stage. Depending on the stage of your cancer, your doctor may recommend active surveillance, radiation therapy, surgery, hormone therapy or palliative care.
  • Patient demographics. Patient demographics play a key role in determining which type of treatment you will receive. For example: the younger the patient, the more aggressive the prostate cancer, meaning that a younger man will get more aggressive treatment than an older man. In addition, if you are Black or over age 60, you are at higher risk for prostate cancer.
  • Patient lifestyle. Certain lifestyle behaviors – such as poor diet, lack of exercise, alcohol consumption and smoking – can raise your prostate cancer risk.

What treatment options do I have?

Siteman provides world-class care that includes all types of treatment, the most advanced technology available and experts who deliver the highest standard of care. We also offer a range of prostate cancer treatment options for all stages of prostate cancer.

Radiation therapy for prostate cancer

Radiation therapy involves the use of energy to attack cancer cells. Our radiation oncology team tailors radiation therapy to each patient’s needs and uses innovative techniques to target the tumor while sparing healthy tissue. This type of therapy often requires multiple treatment sessions.

Radiation techniques that are offered at Siteman include:

  • External beam radiation
  • Brachytherapy
  • Proton beam therapy
  • Radium-223

Surgery for prostate cancer

Washington University urologic oncologists at Siteman only recommend surgery for prostate cancer when it’s absolutely necessary. The two main procedures used to treat prostate cancer are radical prostatectomy (removal of the prostate) and transurethral resection of the prostate (removal of a portion of prostate tissue).

When prostate cancer patients need surgery, our surgeons use minimally invasive methods whenever possible to minimize the risk of side effects, reduce pain and speed up recovery time.

At Siteman, we offer an array of minimally invasive prostate cancer treatment options. These include:

  • Laparoscopic and robotic radical prostatectomy: a surgeon makes several small keyhole incisions in the abdomen and removes the entire prostate along with nearby tissues.
  • Cryoablation: a surgeon inserts a small probe into the prostate that produces cool gas. This gas then freezes and destroys cancer cells.
  • Focal laser ablation: highly targeted heat is directed at a very small area of the prostate to burn away cancerous tissue.
  • High-frequency and high-intensity frequency ultrasound (HIFU): a surgeon inserts an ultrasound probe into the rectum that produces high-frequency sound waves. These sound waves use heat to target and then destroy cancerous tissue.

Systemic therapies for prostate cancer

Systemic therapies are drugs that travel through the blood and attack cancer cells throughout the whole body. For this reason, systemic therapies are usually the best option for treating advanced prostate cancers.

Hormone therapy: this type of treatment stops testosterone from being produced or prevents it from reaching prostate cancer cells. Because most prostate cancer cells rely on testosterone to grow, hormone therapy kills cancer cells or causes them to grow more slowly.

Chemotherapy: this type of treatment involves anti-cancer drugs that are given either by injection into a vein or by mouth. Once administered, the drugs travel through the bloodstream and attack cancer cells in most parts of the body.

Immunotherapy: this type of treatment involves the use of drugs to trigger a person’s own immune system to help kill cancer cells. The only form of immunotherapy currently approved to treat prostate cancer is Provenge®, a personalized cancer vaccine tailored to each patient’s immune system.

Be your own prostate cancer advocate

As a prostate cancer patient, it’s very important for you to be your own advocate. Being aware of your diagnosis as well as your treatment options gives you the best possible chances at a positive outcome. Be sure to speak with your doctor about any questions or concerns you may have about your treatment.

Our prostate cancer specialist team

The prostate cancer specialist team at Siteman comprises outstanding Washington University medical oncologists, radiation oncologists, surgeons, urologists and psychologists.

Meet some of the experts on our team:

Jeff Michalski, MD, MBA

MichalskiDr. Michalski is the vice chair and director of clinical programs in the Department of Radiation Oncology and the Carlos A. Perez Distinguished Professor of Radiation Oncology at Washington University School of Medicine. He is also the president-elect of the American Society of Radiation Oncology (ASTRO). He specializes in radiation oncology with a focus on genitourinary cancers. Dr. Michalski is a national expert in genitourinary cancers, pediatric cancers and survivorship care with extensive experience in leading and supporting clinical trials.

Sam Bhayani, MD

Dr. Bhayani is the director of the Division of Urologic Surgery at Washington University School of Medicine and the chief medical officer of Washington University Physicians. He specializes in the treatment of kidney and prostate cancer using innovative approaches, including robotic surgery. Dr. Bhayani is a national leader in robotic surgery and has helped develop leading-edge surgical techniques to remove prostate and kidney cancers.




You’re considering all of your prostate cancer treatment options. What next?

If you’ve received a prostate cancer diagnosis, you may be feeling a wave of emotions including fear, anger and sadness. But as scary as this time may be, you can take comfort in knowing that Siteman providers are here to support you every step of the way throughout your cancer journey. With our exceptional physicians, psychology services and survivorship care, we are committed to caring for your body, mind and wellness, even after treatment ends.

If you are concerned about your prostate cancer risk, please make an appointment with your primary care provider. If you have been diagnosed with prostate cancer and would like to discuss your treatment options with a prostate cancer specialist at Siteman, please call 800-600-3606.