Prostate Cancer Treatment

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We strongly believe there is no “one-size-fits-all” when it comes to treating prostate cancer. Your age, general health, lifestyle and the way your cancer behaves and responds to treatment factor into the personalized treatment plan we develop with you. Our urologists in Philadelphia, Bala Cynwyd, East Norriton and Lansdale will help you consider all options to come up with the best plan for a longer life with minimal side effects.

Delivering complex care that is specific to your needs requires a highly trained and dedicated team of professionals with the most advanced treatment options available. Many of our physicians have been recognized as Top Doctors™.  Trusted and proven treatment options include: 

  • Active surveillance (also known as watchful waiting) 
  • Surgery
  • Radiation therapy
  • Chemotherapy
  • Hormone therapy
  • Bisphosphonate therapy

Newer treatment methods include:

  • Biologic or immunotherapy
  • Cryotherapy
  • Proton beam therapy

Active Surveillance

Active surveillance is most often used for men who do not have signs or symptoms or who are older or have other medical conditions. We closely monitor your condition without treatment until signs or symptoms appear or change. Treatment may be given to relieve symptoms and improve quality of life, or to cure the disease if cancer begins to grow.

Surgery

If you are in good health and your tumor is in the prostate gland only, we may surgically remove the tumor. Types of surgery include:

Radical prostatectomy: a surgical procedure to remove the prostate, surrounding tissue and seminal vesicles. There are two types of radical prostatectomy:

  • Retropubic prostatectomy: surgical removal of the prostate through an incision in the abdomen. Removal of nearby lymph nodes may be done at the same time.
  • Perineal prostatectomy: removal of the prostate through an incision in the perineum (area between the scrotum and anus). Nearby lymph nodes may also be removed through a separate incision in the abdomen.

Our surgeons are experienced with robotic assisted laparoscopic prostatectomy, which has advantages over traditional open surgery that include less pain and faster recovery.

Pelvic lymphadenectomy: surgical removal and examination of the lymph nodes in the pelvis. 

Transurethral resection of the prostate (TURP): surgical removal of tissue from the prostate using a resectoscope (a thin, lighted tube with a cutting tool) inserted through the urethra. This procedure is done to treat BPH and is sometimes used to relieve symptoms caused by a tumor before other cancer treatment is given. TURP may also be an option if your tumor is in the prostate only and you cannot have a radical prostatectomy.

Surgical advancements in recent years have greatly lessened side effects, but there is still a risk for possible problems that include:

  • Erectile dysfunction
  • Incontinence
  • Shortening of the penis (1 to 2 centimeters)
  • Inguinal hernia 

Together, we will design a treatment plan that offers the best quality of life and fewest side effects. In some cases we can use nerve-sparing surgery to save the nerves that control erection. We also have surgeons that specialize in reconstructive surgery and incontinence to minimize long-term effects.

Radiation Therapy

Radiation therapy uses high-energy X-rays or other types of radiation to kill cancer cells or keep them from growing. The way radiation therapy is given depends on the type and stage of the cancer being treated. There are different types of radiation therapy:

External radiation therapy uses a machine outside the body to send radiation toward the cancer. Conformal radiation is a type of external radiation therapy that uses a computer to create a 3-dimensional picture of the tumor. The radiation beams are shaped to fit the tumor.

Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires or catheters that are placed directly into or near the cancer. The placement of the radioactive seeds in the prostate is guided by images from transrectal ultrasound or computed tomography (CT). 

Xofigo (radium-223) uses radium injected into a vein to treat prostate cancer that has spread to the bone. The radium-223 collects in areas of bone with cancer and kills the cancer cells. This can extend life and/or relieve symptoms and improve quality of life.

Radiation therapy can cause erectile dysfunction (ED) and urinary problems. We will design treatment that has the lowest chance of long-term effects. We also have physicians who specialize in ED and incontinence to minimize long-term effects.

Our free-standing Philadelphia Treatment Radiation Oncology Center offers advanced technology and academic research excellence in a uniquely comfortable and supportive environment.

Chemotherapy

Chemotherapy uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. It can be taken by mouth or injected into the bloodstream to reach cancer cells throughout the body (systemic chemotherapy), or be placed directly into a specific area to kill cancer cells (regional chemotherapy). The way chemotherapy is given depends on the type and stage of your cancer.

Hormone therapy

Hormone therapy removes hormones or blocks their action and stops cancer cells from growing. Hormones are substances made by glands in the body and circulated in the bloodstream. In prostate cancer, male sex hormones (such as testosterone) can cause prostate cancer to grow. Drugs, surgery or other hormones are used to reduce the amount of male hormones or block them from working. Hormone therapy is usually used in conjunction with other treatment, especially radiation therapy.

Hot flashes, impaired sexual function, loss of desire for sex and weakened bones may occur in men treated with hormone therapy. Other side effects include diarrhea, nausea and itching. We will work with you to find treatments that offer the fewest side effects and best quality of life.

Bisphosphonate therapy

Bisphosphonate drugs reduce bone disease when cancer has spread to the bone. Men who are treated with hormone therapy are at an increased risk of bone loss. Bisphosphonate drugs lessen the risk of bone fracture. 

Many studies are underway to find new and better ways of treating prostate cancer or lessening its effects. Urologic Consultants has participated in many of these studies. New types of treatment offered now or in testing through clinical trials include:

Biologic or immunotherapy (Provenge)

Biologic or immunotherapy boosts your body’s immune system to fight cancer. The rapidly advancing field of cancer immunology has recently produced several new methods to strengthen immune responses against tumors. We currently offer Provenge (sipuleucel-T), an FDA-approved biologic therapy used to treat prostate cancer that has spread (metastasized) to other parts of the body. 

High-intensity focused ultrasound (HIFU)

HIFU uses ultrasound (high-energy sound waves) to destroy cancer cells. We have offered study participation to select men who are good candidates for HIFU therapy. 

Cryotherapy

Cryotherapy uses an instrument to freeze and destroy prostate cancer cells. We do not offer cryotherapy at UC.

Proton beam radiation therapy

This is a type of high-energy, external radiation therapy that targets tumors with streams of protons (small, positively charged particles). We do not offer proton beam therapy at UC.

Clinical Trials

A clinical trial is a research study to help improve current treatments or obtain information on new treatments for patients with cancer. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment. Some clinical trials are open only to patients who have not started treatment, while others are open to patients in active treatment or with recurrent cancer. There are also clinical trials that test new ways to reduce the side effects of cancer treatment.

Urologic Consultants is actively involved with clinical trials, and many of today’s standard treatments were investigated through our practice. We can talk with you about clinical trials that may be appropriate for you. Our research team travels from its hub in Bala Cynwyd to our offices in Philadelphia, East Norriton and Lansdale so you do not need to go far to participate in most trials.