Prostate Cancer Treatment Options
Prostate cancer is a complex disease. In some cases, it grows slowly and may never move beyond the prostate; in other cases, it may be aggressive or advanced disease.
While the choice you make for your treatment is a personal and individual one, a key to making a good decision is getting input from an experienced team of leading prostate cancer specialists who know the outcomes and quality-of-life issues associated with each type of treatment.
The treatment your Seattle Cancer Care Alliance (SCCA) team recommends will depend on the grade and stage of your prostate cancer and several other factors, including your age, your general health, potential side effects of treatment, and the probability of curing your disease, extending your life, or relieving your symptoms. As an SCCA patient, you have access to all the treatment options currently available, as well as new therapies offered only in clinical studies.
Today’s treatment options reflect intensive and successful efforts to maximize the chance for a cure while minimizing side effects. They typically focus on controlling cancer within the prostate gland with the least possible effects on healthy organs nearby.
Advances Through Research
The Institute for Prostate Cancer Research, a collaboration between UW Medicine and Fred Hutchinson Cancer Research Center, two of SCCA’s founding organizations, has analyzed 86 different genes and determined which genes were turned on in low-grade (less aggressive) prostate cancer cells and which were turned on in high-grade (more aggressive) cells. This is the first systematic attempt to distinguish these molecular features so doctors can more objectively predict how an individual’s prostate cancer will behave—and, thus, they can better select appropriate therapies.
Treating Localized Prostate Cancer
For nearly 80 percent of men with prostate cancer, the disease is diagnosed early, in the local or regional stages. Doctors expect the majority of them will be cured. Active surveillance, watchful waiting, radiation therapy, and surgery (prostatectomy) are the most common treatments for these men.
Treating High-Risk or Recurrent Prostate Cancer
One in five men with prostate cancer is diagnosed with high-risk disease, which is localized prostate cancer that has a tendency to spread, or metastasize. And, despite being treated for prostate cancer, a number of men will suffer a relapse, meaning their cancer returns. For men in one of these situations, there are special considerations. Learn more about treating high-risk or recurrent prostate cancer.
Treating Advanced Prostate Cancer
In some cases, prostate cancer has already spread to other parts of the body by the time a man learns he has the disease. Advanced, or metastatic, prostate cancer cannot be cured, but new treatments may put your cancer in remission and give you a good quality of life for years. If you have advanced prostate cancer, SCCA can offer you new medical procedures and treatments, as well as access to clinical studies, that your community doctor may not know about. In addition to offering you clinical studies, your SCCA team may recommend treating your cancer with immunotherapy, hormone therapy, chemotherapy, or radiation therapy. No one at SCCA will tell you that a diagnosis of advanced prostate cancer is not serious, but there is hope.
Depending on the course of treatment for your prostate cancer, you may be treated at one or more of these SCCA locations:
- The Prostate Oncology Center at University of Washington Medical Center
- The SCCA outpatient clinic on Lake Union
- Halvorson Cancer Center, a partnership between SCCA and EvergreenHealth
- UW Medicine’s Northwest Hospital & Medical Center
- SCCA Proton Therapy, A ProCure Center
If you have just been diagnosed with prostate cancer, you’re probably thinking hard about what to do next. An important consideration is where to get treated. SCCA patients have better outcomes than those who are treated elsewhere.
Active surveillance and watchful waiting are ways to manage early-stage, slow-growing, or asymptomatic prostate cancer. Your team may also recommend these options if your life expectancy is less than 10 years or you can’t have or don’t want aggressive treatment.
Surgery offers a good chance to cure patients with early-stage cancer that is localized to the prostate. The most common surgery is a radical prostatectomy, which may be done using open surgical methods or laparoscopically with or without robotic aides.
Radiation therapy may be used as a curative treatment for localized prostate cancer or as palliative therapy for advanced prostate cancer. At SCCA, we use the latest technology to provide the most precise radiation treatment possible.
Proton therapy is a form of radiation treatment that allows doctors to focus radiation precisely on the tumor while limiting radiation to surrounding healthy tissue, which makes it ideal for treating anatomically complex tumors, like prostate cancer.
Hormone therapy may be recommended for advanced prostate cancer, when PSA levels are rising despite previous prostate cancer treatment, or if you aren’t able to have surgery or radiation therapy for your disease.
Immunotherapy holds promise as a novel treatment with low toxicity that can extend life in men with advanced prostate cancer. Active immunotherapies, including the vaccine Provenge, are based on exploiting the patient’s own immune system to fight the cancer.
If you have been diagnosed with advanced prostate cancer or if your cancer has returned after treatment, your doctor may recommend chemotherapy.
Studies suggest that maintaining a healthy diet and engaging in regular exercise may lower prostate cancer risk. A healthy lifestyle also can help you prepare for and recover after cancer treatment and may help keep your cancer from coming back.
Treatments for prostate cancer may have side effects, which can include infertility, incontinence, reduced sexual desire, erectile dysfunction, and changes in orgasm.
Your team will monitor you for 10 years after you’ve been treated for prostate cancer. The frequency of your follow-up visits will depend on several factors, including the stage of your cancer and your response to treatment.