Prostate Cancer Treatment
Your unique needs require personalized treatment options for prostate cancer.
To treat prostate cancer and meet your needs, we will use objective analysis, optimal approaches, and advanced technology. Your team of urologists, oncologists, and surgeons will be part of our tumor board. These and other specialists will identify the type of prostate cancer, tumor size, and stage. After considering your health and other factors, they will create a tailored treatment plan which may include:
In a supportive environment, you can learn about the most current options for preserving fertility. Before any treatment begins, ask to have a consultation with our fertility specialists. Often, appointments can be made within 24 hours.
Adenocarcinoma is the most common type of prostate cancer, and there are several rare types of the disease. The specific type of prostate cancer will indicate the type of treatment that should be given. In some cases, your doctor may recommend a watch-closely approach. It may involve having a periodic digital rectal exam, biopsy, and PSA screening. However, you may need treatment, such as surgery, laser therapy, radiation therapy, or chemotherapy. Any treatment for prostate cancer can disrupt fertility. Experts are available to discuss options and answer your questions.
The type of treatment chosen to remove prostate cancer will depend on the amount of the cancer in the body. Our tumor board will carefully evaluate your condition and determine the best approach.
Advanced and minimally invasive surgery
Our surgeons are worldwide leaders of innovative techniques for treating prostate cancer. They are global experts in performing minimally invasive surgery and have extensive experience in performing surgery by making small incisions instead of large ones. That’s important for our patients – they benefit from advanced cancer treatment with fewer complications. In addition, our patients have faster recovery times, less discomfort, less blood loss, and less scaring. Hospital stays are shorter and men can return to their normal activities sooner.
Our prostate surgery options include robotic radical prostatectomy, laparoscopic radical prostatectomy, and traditional open radical prostatectomy.
When prostate cancer has spread, or metastasized, radiation therapy may be used. It may also be used to destroy any cancer cells that may remain after surgery. Radiation therapy damages the DNA of cancer cells so the cells stop growing and die. However, it may take weeks of treatment before the cancer cells begin dying. After radiation ends, the cancer cells may continue dying for months. The dead cells are broken down and eliminated from the body.
Henry Ford is a world leader in new approaches to radiation therapy and the fast-developing field of radiosurgery, a type of radiation that uses precise, advanced technology to deliver higher doses of radiation in fewer sessions. Our options for radiation therapy for prostate cancer include:
- MRI-guided radiation therapy, known as ViewRay MRIdian Linac, may be an option for select patients. This technology provides precise and accurate radiation treatment. To help protect healthy tissue near cancer cells, imaging is done at the same time radiation treatment is done. This allows physicians to accurately target the cancer cells and use a strong dose of radiation to kill the cancer.
- External beam radiation therapy (EBRT) involves using high-energy rays to kill prostate cancer. The rays are similar to X-rays, and the painless treatment is often used for low-grade cancer.
- Three-dimension conformal radiation therapy (3D-CAT) uses special computers to find the precise location of the prostate cancer. From several directions, the radiation beams are aimed at the prostate gland, making it less likely to damage normal tissue
- Intensity modulated radiation therapy (IMRT) involves using a machine that moves and delivers radiation to the prostate. To allow the doctor to provide higher doses of radiation, the beams are shaped and precisely aimed. This treatment may take weeks to complete.
- Image-guided radiation therapy (IGRT) allows the doctor to take images of the prostate so adjustments can be made immediately before aiming the radiation beams.
- Stereotactic body radiation therapy (SBRT) involves delivering a large dose of radiation to precisely obliterate cancer cells in the prostate. The treatment may be completed in a few days, but the side effects may be greater than with IGRT.
- Internal radiation therapy (brachytherapy or interstitial brachytherapy) involves inserting about 100 tiny seeds directly into the prostate while the patient is in the operating room. The treatment is often used for low-grade and slow-growing cancer, or it may be used in addition to external beam therapy for higher-risk cancer growing outside the prostate.
This treatment involves freezing cancerous and abnormal tissue in the prostate gland. Using ultrasound for guidance, needles are inserted into the prostate. Then the needles deliver a freezing gas to destroy the prostate tissue.
To fight some types of prostate cancer, hormone therapy may be used. Male hormones are called androgens, and they can stimulate the growth of cancer cells in the prostate. Therapy to stop or reduce the levels of male hormones is called androgen suppression therapy or androgen deprivation therapy (ADT). Hormone therapy may shrink prostate cancer or cause cells to grow more slowly.
Chemotherapy uses drugs to damage or destroy cancer cells at certain stages of the disease. Our prostate cancer team includes physicians called medical oncologists who specialize in the administration of chemotherapy. They will customize the best treatment, which may include:
- Adjuvant chemotherapy is often given after surgery. This chemotherapy is used to kill any remaining cancer cells that may have spread or were not seen during surgery. In many cases, it can reduce the risk of new cancerous tumors.
- Neoadjuvant chemotherapy may be given before surgery in some cases. Neoadjuvant chemotherapy may be used to shrink large tumors, so less extensive surgery will be required. This type of chemotherapy can decrease the risk of the cancer returning. Also, it can kill cancer cells that are unseen because they have moved away from the original tumor site.
Active surveillance is an approach that involves closely monitoring slow-growing prostate cancer. This may be done when the cancer is small and just in the prostate. Monitoring is typically done every six months, and it includes a digital-rectal exam (DRE) and a PSA blood test. Every year, a prostate biopsy may be done.
Watchful waiting is another approach that is less intense and involves observing the symptoms of prostate cancer. If symptoms increase, testing or treatments may be needed.
Fertility preservation options
Chemotherapy and radiation therapy can damage the DNA in sperm. This can cause miscarriages and serious abnormalities in the baby. In many cases, the therapy may cause infertility. If you want to preserve your fertility, talk with your doctor about the risks and benefits of any proposed prostate cancer treatments. Certain fertility preservation procedures may be available.
- Radiation shielding involves using a lead shield to protect one or both of the testicles from the scattering X-rays during radiation treatment. After treatment, unprotected sexual activity should be avoided for a period of time.
- Sperm banking involves collecting semen by masturbation, by help from a partner’s stimulation, or by a vibratory stimulation device. Semen is taken to a sperm bank within one hour. A sperm cell count will be taken and the percentage of normal-shaped sperm and sperm that are able to swim will be estimated. Then the cells are frozen and stored.
Medical research, known as clinical trials, is constantly being done to find better ways of treating prostate cancer. Enrolling in a clinical trial may provide treatment options that are still under exploration. At Henry Ford, our research nurse will work with you to find the clinical trial for a new drug or treatment approach that meets your needs.
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