What are Treatment Options for Prostate Cancer?
Not all prostate cancers are the same and the best treatment can be different for each individual. Current treatment options include active surveillance, radical prostatectomy, radiation therapy, cryotherapy, and androgen deprivation.
Some prostate cancers do not require immediate treatment and can be monitored. This involves regular PSA, DRE and prostate biopsies. This approach allows for a better quality of life when the cancer is slow growing, and when there is evidence that the cancer is progressing, a treatment is offered. Not all patients are candidates for this approach, and it typically requires a cancer diagnosed at a very early stage.
A prostatectomy involves removing the prostate gland, seminal vesicles, and associated tissues. A prostatectomy can be performed with the da Vinci robot or in an open procedure. The entire prostate gland most be removed because the cancer cells are often scattered throughout the gland in an unpredictable manner. When done robotically, patients typically have a shorter hospital stay, less postoperative pain, and faster return of urinary continence. The surgeons of CUC have performed over 1000 robotic prostatectomies with overall excellent results.
Radiation Therapy and Prostate Cancer
Radiation therapy uses high energy x-rays to kill cancer cells. This can be delivered in several different ways.
- Intensity Modulated Radiation Therapy and Image Guided Radiation Therapy (IMRT and IGRT): the radiation energy is conformed to the tumor and delivered five days per week for an eight week period. Each treatment is only minutes long. Daily imaging of the prostate and surrounding structures can allow for a more precise, focused treatment.
- Brachytherapy: this is short, outpatient surgical procedure in which small radioactive seeds are permanently implanted into the prostate to gradually release radiation and destroy the cancer cells.
- Proton therapy: a form of radiation therapy in which a different form of energy (not standard X-rays) are focused on the prostate.
Prostate cancer is stimulated by testosterone produced in the testicles. Androgen deprivation involves medications that lower or block the effects of testosterone, which causes the cancer to shrink or slow in its growth. These medications are typically given in injection form. Androgen deprivation cannot cure prostate cancer but it can extend a patient’s life. This treatment is used when a cancer recurs or, in some cases, to supplement radiation therapy.
Advanced Prostate Cancer Treatment
Despite advances in treatment for localized prostate cancer, some patients have their cancer recur or they present with disease that has already spread to other parts of the body. In most of these cases the likelihood of complete cure is low. The cancer can however be controlled through the use of multiple treatment modalities, in some cases, for many years.
Dr. Richard Troy is an expert in advanced prostate cancer treatment.
Many patients with advanced prostate cancer are seen in our Champions Clinic. This is currently run out of our Lake Barrington facility and is overseen by Dr. Richard Troy. The Clinic helps organize patients’ treatment plans, monitor responses to treatments, monitor bone health, and assess for any complications.
Many of the latest advanced treatments for prostate cancer are offered, including androgen deprivation (Lupron and Firmagon), Provenge immunotherapy, Prolia, Xgeva, and Zytiga.
The Champions Clinic is a comprehensive cancer care program incorporating not only the recent medical, surgical and radiation treatments, but also providing resources addressing our patients health and wellness needs. Lifestyle counseling, weight management and exercise programs are available through the Champions clinic. Dr. Troy has established relationships with local palliative care, wellness, and hospice programs and makes referrals to these organizations when appropriate.
Which Prostate Cancer Treatment is Right for me?
Every patient and every cancer is unique. Treatment decisions need to factor in age, medical history, specifics the cancer grade and stage, and treatment goals. It is important to discuss your specific situation with your urologist. If you are interested in discussing prostate cancer and treatment options with a CUC urologist, please contact us to schedule a consultation.