Treatment

Prostate Cancer Treatment

There are a number of approaches to treating prostate cancer. At Siteman Cancer Center, our Washington University Physicians custom-build a treatment plan for each patient, drawing upon the latest scientific research and the most advanced therapies and tools. Sometimes, they even decide that the best course of treatment is actually no treatment at all.

How is prostate cancer treated at Siteman?

The standard treatments for prostate cancer at Siteman Cancer Center are:

  • Surgery
  • Radiation therapy
  • Systemic therapy
  • Active surveillance
  • Focal therapy

What is active surveillance for prostate cancer?

“Active surveillance” means monitoring a low-grade and non-aggressive prostate cancer instead of pursuing immediate treatment. Many prostate cancers that are diagnosed early with PSA screening can be watched safely; they will not cause the patient any pain or impact his quality of life before the conclusion of his natural lifespan.

Before opting for active surveillance, the most important consideration is that you have undergone the best testing to ensure that your prostate cancer is in fact safe to track.  As a direct result of research that Siteman urologists have led, we know that many patients with low risk prostate cancers are safe for active surveillance.

If you and your physician choose active surveillance, you will check in with your medical team on a regular basis to make sure the prostate cancer has not changed. Some active surveillance patients at Siteman are eligible to join clinical trials for immunotherapies as an extra safeguard against rapid or sudden cancer growth. Ask your physician if this could be an option for you.

What is focal therapy?

This novel approach to treating prostate cancer destroys the tumor within the prostate. Not all prostate cancers can be treated safely with focal therapy, and this is an ongoing area of research. We do know that high-quality imaging is critical. By visualizing the tumor with precision on MRI scans or other imaging tests, surgeons can use various sources of energy, such as cryoablation (freezing), laser ablation, or high frequency ultrasound to get rid of the tumor.  High-intensity frequency ultrasound (HIFU) can also destroy the tumor without harming the prostate.

Focal therapy can successfully remove the prostate cancer without damaging the rest of the prostate gland, thus minimizing the risk of urinary or sexual side effects.

What surgical procedures are used to treat prostate cancer?

Two main procedures are used in the treatment of prostate cancer:

  • Radical prostatectomy
  • Transurethral resection of the prostate

A prostatectomy is a procedure to remove the prostate gland. This is performed to cure the prostate cancer.

During a transurethral resection of the prostate, the surgeon does not take out the entire prostate, but instead removes a portion of prostate tissue. Patients might undergo this procedure as part of a broader treatment program.

What is radiation therapy for prostate cancer?

Radiation to the prostate is given with the intent of curing the cancer. It can sometimes be used as an alternative to surgery. Patients with lower-risk disease can be treated with radiation alone, often with shorter courses to minimize the number of trips to the treatment center. Radiation can also be given to relieve cancer symptoms.

The radiation therapy options available to patients at Siteman include:

  • Intensity-modulated radiation therapy (IMRT)
  • Brachytherapy, given as low-dose-rate (LDR) or high-dose-rate (HDR)
  • Proton beam therapy
  • Radium-223

If you undergo radiation therapy at Siteman, your physicians will do their utmost to ensure that you are treated effectively and safely. Siteman’s radiation oncology team has developed new methods to target prostate cancer without impacting surrounding, healthy tissue.

What is systemic therapy for prostate cancer?

Systemic therapies for prostate cancer treat cancer cells in the prostate as well as those that have spread to other locations around the body. The patient can ingest them as pills or receive them through an IV or an injection.

Hormone therapy is the main systemic therapy used in the treatment of prostate cancer. It prevents prostate cancer cells from obtaining the hormones they need to grow. Patients may receive chemotherapy in certain cases.

Washington University Physicians at Siteman use newer drugs, including new hormonal and immunotherapies, to fight prostate cancer. Some of these therapies take away cancer cells’ ability to spread through new tissues or form new blood vessels. They also have pioneered studies of effective systemic therapy for patients with advanced prostate cancer.

  • Click here to learn more about systemic therapies at Siteman.