Prostate cancer

Prostate cancer overview

You are at the center of everything we do at the Prostate Oncology Center at Fred Hutchinson Cancer Center. Here, we surround you with a team of specialists who work together closely to provide expert, targeted care and compassionate support throughout your treatment and beyond.

We guide you every step of the way, combining our deep clinical expertise in prostate cancer with a commitment to meet your unique needs. Together, our scientists and clinicians — from UW Medicine and Fred Hutch — provide hope for men with prostate cancer and their families not only in the Northwest but also around the world.

Following the merger of long-time partners, Fred Hutchinson Cancer Research Center and Seattle Cancer Care Alliance, the organization was renamed to Fred Hutchinson Cancer Center. We are an independent, nonprofit organization that also serves as UW Medicine's cancer program. 

Why choose Fred Hutch?

  • Multidisciplinary prostate cancer team
    We bring together experienced, nationally known urologic oncologists, radiation oncologists and medical oncologists who specialize in prostate and genitourinary cancers. You may choose to visit one of our specialists for a specific type of treatment or take a team approach.
  • Comprehensive prostate cancer treatment 
    Our doctors are experts in the full spectrum of complex treatments prostate cancer may require. Based on the unique characteristics of your tumor, your team may recommend active surveillance, watchful waiting, radical prostatectomy, proton therapy or other radiation treatment, hormone treatment, immunotherapy or chemotherapy, all available at Fred Hutch.
  • Prostate cancer clinical trials
    To give you access to the most innovative therapies, we unite the leading researchers and cancer specialists of Fred Hutch and UW Medicine so you can take part in prostate cancer clinical studies not available everywhere.
  • Advancing care through research
    The Fred Hutch Prostate Oncology Center has set the standard of care for the nation, and we’re moving it forward. World-renowned investigators at the Institute for Prostate Cancer Research, a Fred Hutch–UW Medicine collaboration, have developed many new therapeutic strategies and are working to understand prostate cancer causes and progression, develop new prevention methods, devise innovative diagnostics and improve survival and quality of life. Fred Hutch researchers are also on the Stand Up 2 Cancer Prostate Cancer Dream Team.
  • A national leader in cancer care
    Fred Hutch is the leading cancer treatment center in the region and among the top nationally, according to U.S. News & World Report. 
  • NCI comprehensive cancer center
    We are a comprehensive cancer center, a designation from the National Cancer Institute that reflects our scientific leadership and the depth and breadth of our research to prevent, diagnose and treat cancer.
Chemotherapy Treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. It may be given alone or with other treatments. Treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Chemotherapy may be given by mouth, injection, infusion or on the skin, depending on the type and stage of the cancer being treated. It may be given alone or with other treatments, such as surgery, radiation therapy or biologic therapy. Clinical trial A type of research study that tests how well new medical approaches work in people. These studies test new methods of screening, prevention, diagnosis or treatment of a disease. Hormone therapy Hormones can cause some cancers to grow. To slow or stop growth, synthetic hormones or other drugs can be used to block the body’s natural hormones, or surgery is used to remove a hormone-producing gland. Treatment that adds, blocks or removes hormones. For certain conditions (such as diabetes or menopause), hormones are given to adjust low hormone levels. Hormones can also cause certain cancers (such as prostate and breast cancer) to grow. To slow or stop the growth of cancer, synthetic hormones or other drugs can be used to block the body’s natural hormones, or surgery is used to remove the gland that makes a certain hormone. Also called endocrine therapy, hormonal therapy and hormone treatment. Immunotherapy A type of therapy that uses substances to stimulate or suppress the immune system to help the body fight cancer, infection and other diseases. A therapy that uses substances to stimulate or suppress the immune system to help the body fight cancer, infection and other diseases. Some immunotherapies only target certain cells of the immune system. Others affect the immune system in a general way. Types of immunotherapy include cytokines, vaccines, bacillus Calmette-Guerin (BCG) and some monoclonal antibodies. Progression In medicine, the course of a disease, such as cancer, as it becomes worse or spreads in the body. Radiation oncologist A physician who has special training in using radiation to treat cancer. Standard care A treatment or other intervention currently being used and considered to be of proven effectiveness based on past studies. Surveillance Closely watching a patient’s condition but not treating it unless there are changes in test results. Surveillance is also used to find early signs that a disease has come back. In medicine, surveillance means closely watching a patient’s condition but not treating it unless there are changes in test results. Surveillance is also used to find early signs that a disease has come back. It may also be used for a person who has an increased risk of a disease, such as cancer. During surveillance, certain exams and tests are done on a regular schedule. In public health, surveillance may also refer to the ongoing collection of information about a disease, such as cancer, in a certain group of people. The information collected may include where the disease occurs in a population and whether it affects people of a certain gender, age or ethnic group. Watchful waiting Closely watching a patient’s condition but not giving treatment unless symptoms appear or change. During watchful waiting, patients may be given certain tests and exams. Closely watching a patient’s condition but not giving treatment unless symptoms appear or change. Watchful waiting is sometimes used in conditions that progress slowly. It is also used when the risks of treatment are greater than the possible benefits. During watchful waiting, patients may be given certain tests and exams. Watchful waiting is sometimes used in prostate cancer. It is a type of expectant management.
Second opinions

If you’ve been diagnosed with prostate cancer, we recommend getting a second opinion before selecting a course of treatment. Getting a second opinion is more than a formality. It’s a valuable way to verify facts, like the stage, the location and even the existence of the disease. A second opinion may provide you access to new prostate cancer treatments or clinical studies that are available for men in your specific situation.

If you have received a prostate cancer diagnosis, a second opinion makes sense for the following reasons:

  • Prostate cancer can be a complex disease to treat, and there are many opinions about how best to treat it.
  • You have time. In most cases, prostate cancer is a slow-growing disease; in some cases, it may develop over a 10- to 20-year period and never move beyond the prostate. Unless your doctor tells you otherwise, you can most likely take one to three months to learn all you can to make a calculated, deliberate plan of action for treating your disease.
  • It’s important to avoid overtreatment. It’s been well documented1 that prostate cancer has been overtreated, meaning some men with the disease have undergone treatments they did not need. That’s one reason why Fred Hutch is a proponent of active surveillance for dealing with slow-growing prostate cancer.
  • Changing treatment regimens is not always easy or possible. Once you start a course of treatment, it’s sometimes hard to change to something else, especially if you’ve elected surgery or radiation. So it’s important to be well informed and make the best possible decisions from the outset.

Take your time, and find a urologic oncologist you trust and a course of treatment you’re comfortable with. If you weren’t diagnosed at Fred Hutch, request an appointment with one of our many prostate cancer specialists, who are all University of Washington faculty members. 

And if you received your diagnosis here at Fred Hutch, don’t be afraid to ask your doctor about getting a second opinion. They’ll be more than happy to provide you with a list of recommended doctors to consult with.

1. Roberto Daza, “Research Aims to Prevent Overtreatment of Prostate Cancer,” The Seattle Times, August 17, 2011.
    Clinical trial A type of research study that tests how well new medical approaches work in people. These studies test new methods of screening, prevention, diagnosis or treatment of a disease. Oncologist A physician who has special training in diagnosing and treating cancer. Some oncologists specialize in a particular type of cancer treatment, such as treating cancer with radiation. A physician who has special training in diagnosing and treating cancer. Some oncologists specialize in a particular type of cancer treatment. For example, a radiation oncologist specializes in treating cancer with radiation. Stage The extent of a cancer in the body. Staging is usually based on the size of the tumor, whether lymph nodes contain cancer and whether the cancer has spread from the original site to other parts of the body. Surveillance Closely watching a patient’s condition but not treating it unless there are changes in test results. Surveillance is also used to find early signs that a disease has come back. In medicine, surveillance means closely watching a patient’s condition but not treating it unless there are changes in test results. Surveillance is also used to find early signs that a disease has come back. It may also be used for a person who has an increased risk of a disease, such as cancer. During surveillance, certain exams and tests are done on a regular schedule. In public health, surveillance may also refer to the ongoing collection of information about a disease, such as cancer, in a certain group of people. The information collected may include where the disease occurs in a population and whether it affects people of a certain gender, age or ethnic group.
    Second opinions

    If you’ve been diagnosed with prostate cancer, we recommend getting a second opinion before selecting a course of treatment. 

    Prostate Cancer Multispecialty Clinic

    What is the Prostate Cancer Multispecialty Clinic?

    The PCMC gives you a “home” where you can see a urologic oncologist, medical oncologist and radiation oncologist all on the same day. Our doctors are UW Medicine physicians who specialize in prostate cancer. They work with you as a team to plan and provide the care you need. 
    The clinic is held once a week in the Fred Hutch Genitourinary Oncology Center in the Surgery Pavilion at UW Medical Center – Montlake. 

    As a new patient, you will get a thorough evaluation of your unique case. You will leave your appointment with a complete, personalized treatment plan and a clear set of next steps.

    Along with your physicians, your PCMC team includes:

    • A pathologist and radiologist, who help with diagnosis and treatment planning
    • Nurses and nurse practitioners, who help provide your care
    • Research coordinators, who can explain clinical trials that are testing leading-edge therapies
    • A program coordinator, who ensures your care runs smoothly

    At Fred Hutch, we offer a wide range of supportive care services, like nutrition and physical therapy, to help you thrive. We also have genetics specialists who can help you understand cancer risk in your family and help us find features of your cancer that may affect your treatment plan.

    Who is the PCMC for?

    If you have high-risk, localized prostate cancer, the PCMC is designed for you. We also see patients with newly diagnosed, metastatic prostate cancer who have not yet (or very recently) started hormone therapy and some patients who have a rising prostate-specific antigen (PSA) level after surgery and radiation therapy.

    Why? These people are most likely to benefit from having two or more types of treatment: surgery, medicine-based options (like chemotherapy and immunotherapy) and/or radiation therapy.

    What will happen at my first appointment?

    Your first appointment at the PCMC will usually take about four hours. You will spend about three hours with your physicians. We invite you to bring a friend or family member with you to help keep track of your questions and the information that your team gives you.

    Here’s what you can expect to happen.

    Hour 1 – Exam 

    You will meet with an attending physician, fellow or resident doctor who will talk with you about your health history and do a physical exam.

    Hour 2 – Team meeting

    Your team of physicians will meet to talk with each other about your cancer and the most effective ways to treat it. During this time, you will be free to visit the Patient Resource Center and other UW Medical Center – Montlake amenities.

    Your attending, resident or fellow will present the details they learned from talking with you and examining you. 

    Your care team will review and explain the results of any biopsies, imaging scans and other tests you’ve had. 

    Your urologic oncologist, medical oncologist and radiation oncologist will apply their experience and knowledge about the best treatment approach for people in your situation. 

    Together, the team will design a treatment plan specifically for you.

    Hours 3 and 4 – Recommendations 

    You will meet one-on-one with each physician from your team. You will stay in the same room and the physicians will come to you. We will explain the treatment we recommend for you and why. We’re here to answer your questions and talk through your options so you can make decisions you feel good about. 

    What happens next?

    Before you leave, you will meet the PCMC program coordinator. We will schedule any appointments you need next. Your schedule will depend on your specific situation, but we’re here to handle the details and make the process as worry-free as possible for you.

    Once treatment begins, our patients receive care at our South Lake Union clinic, UW Medical Center – Montlake or both.

    Everyone on our team is used to partnering one-on-one with patients and their families to put in place the plans that are right for them. We want to help you understand as much as you wish to about your disease, your treatment and how care happens here — so you can focus on living your life.

    Antigen A foreign substance, such as bacteria, that causes the body’s immune system to respond by making antibodies. Antibodies defend the body against antigens. Biopsy The removal of a sample of tissue or fluid that is examined to see whether cancer is present. This may be done with a large needle or through surgical removal of tissue or fluids. Chemotherapy Treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. It may be given alone or with other treatments. Treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Chemotherapy may be given by mouth, injection, infusion or on the skin, depending on the type and stage of the cancer being treated. It may be given alone or with other treatments, such as surgery, radiation therapy or biologic therapy. Hormone therapy Hormones can cause some cancers to grow. To slow or stop growth, synthetic hormones or other drugs can be used to block the body’s natural hormones, or surgery is used to remove a hormone-producing gland. Treatment that adds, blocks or removes hormones. For certain conditions (such as diabetes or menopause), hormones are given to adjust low hormone levels. Hormones can also cause certain cancers (such as prostate and breast cancer) to grow. To slow or stop the growth of cancer, synthetic hormones or other drugs can be used to block the body’s natural hormones, or surgery is used to remove the gland that makes a certain hormone. Also called endocrine therapy, hormonal therapy and hormone treatment. Imaging In medicine, a process that makes pictures of areas inside the body. Imaging uses methods such as X-rays (high-energy radiation), ultrasound (high-energy sound waves) and radio waves. Immunotherapy A type of therapy that uses substances to stimulate or suppress the immune system to help the body fight cancer, infection and other diseases. A therapy that uses substances to stimulate or suppress the immune system to help the body fight cancer, infection and other diseases. Some immunotherapies only target certain cells of the immune system. Others affect the immune system in a general way. Types of immunotherapy include cytokines, vaccines, bacillus Calmette-Guerin (BCG) and some monoclonal antibodies. Medical oncologist A physician who has special training in diagnosing and treating cancer in adults using chemotherapy, hormonal therapy, biological therapy and targeted therapy. A physician who has special training in diagnosing and treating cancer in adults using chemotherapy, hormonal therapy, biological therapy and targeted therapy. A medical oncologist is often the main health care provider for someone who has cancer. A medical oncologist also gives supportive care and may coordinate treatment given by other specialists. Metastatic A metastatic cancer is a cancer that has spread to other areas of the body by way of the lymph system or bloodstream. Nurse practitioner A registered nurse who has additional education and training in how to diagnose and treat disease. In cancer care, a nurse practitioner may manage the primary care of patients and their families. A registered nurse who has additional education and training in how to diagnose and treat disease. Nurse practitioners are licensed at the state level and certified by national nursing organizations. In cancer care, a nurse practitioner may manage the primary care of patients and their families, based on a practice agreement with a physician. Oncologist A physician who has special training in diagnosing and treating cancer. Some oncologists specialize in a particular type of cancer treatment, such as treating cancer with radiation. A physician who has special training in diagnosing and treating cancer. Some oncologists specialize in a particular type of cancer treatment. For example, a radiation oncologist specializes in treating cancer with radiation. Pathologist A physician who has special training in identifying diseases by studying cells and tissues under a microscope. Radiation oncologist A physician who has special training in using radiation to treat cancer. Radiation therapy The use of high-energy radiation from X-rays, gamma rays, neutrons, protons and other sources to kill cancer cells and shrink tumors. The use of high-energy radiation from x-rays, gamma rays, neutrons, protons and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body near cancer cells (internal radiation therapy or brachytherapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that travels in the blood to tissues throughout the body. Radiologist A physician who has special training in creating and interpreting pictures of areas inside the body. The pictures are made with X-rays, sound waves or other types of energy. Treatment plan A detailed plan with information about a patient’s disease, the goal of treatment, the treatment options for the disease and the possible side effects and expected length of treatment. A detailed plan with information about a patient’s disease, the goal of treatment, the treatment options for the disease and the possible side effects and expected length of treatment. A treatment plan may also include information about how much the treatment is likely to cost and about regular follow-up care after treatment ends. Urologic oncologist A physician who has special training in diagnosing and treating cancers of the male and female urinary tract and the male reproductive organs.
    Prostate Cancer Multispecialty Clinic

    Many people with prostate cancer may have more than one type of treatment option, which means they need more than one type of physician. At Fred Hutch, we bring a team of genitourinary specialists together for you in one place: the Prostate Cancer Multispecialty Clinic (PCMC). It’s our one-stop shop, where we guide you through complex treatment decisions and provide seamless, comprehensive care.

    Prostate Cancer Genetics Clinic

    Nearly 12 percent of men with advanced prostate cancer carry inherited genes that increase their risk for faster-growing forms of the disease that are more likely to spread. Knowing whether or not a man with prostate cancer carries a gene mutation associated with inherited cancer risk can help physicians select better and more effective treatment options.

    The Fred Hutch Prostate Cancer Genetics Clinic provides counseling and genetic testing, if appropriate, for men with prostate cancer.

    Learn More About the Prostate Cancer Genetics Clinic

    Gene The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. Gene The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. Genetic testing Tests that can be done to see if a person has certain gene changes known to increase cancer risk. Mutation Any change in the DNA sequence of a cell. Mutations may be caused by mistakes during cell division, or they may be caused by exposure to DNA-damaging agents in the environment. Any change in the DNA sequence of a cell. Mutations may be caused by mistakes during cell division, or they may be caused by exposure to DNA-damaging agents in the environment. Mutations can be harmful, beneficial or have no effect. If they occur in cells that make eggs or sperm, they can be inherited; mutations that occur in other types of cells are not inherited. Certain mutations may lead to cancer or other diseases. A mutation is sometimes called a variant.
    Prostate Cancer Genetics Clinic

    Knowing whether or not a man with prostate cancer carries a gene mutation associated with inherited cancer risk can help physicians select better and more effective treatment options.

    Facts

    Prostate cancer is the most common cancer after skin cancer in men in the United States. In some men, it is slow growing and unlikely to cause serious problems. In others, the disease is very aggressive. If it’s detected early, prostate cancer is highly treatable, and most men survive. Fred Hutch offers comprehensive prostate cancer treatment from a team of experts.

    Treatment

    Prostate cancer is complex. There are a lot of things to think about before you and your physician choose a treatment plan. Experts at Fred Hutch offer comprehensive prostate cancer care and can talk with you about your unique situation and the best prostate cancer treatment for you. 

    Treatment plan A detailed plan with information about a patient’s disease, the goal of treatment, the treatment options for the disease and the possible side effects and expected length of treatment. A detailed plan with information about a patient’s disease, the goal of treatment, the treatment options for the disease and the possible side effects and expected length of treatment. A treatment plan may also include information about how much the treatment is likely to cost and about regular follow-up care after treatment ends.

    Providers

    At Fred Hutch, you receive care from a team of providers with extensive experience in your disease. Your team includes physicians, a patient care coordinator, a registered nurse, an advanced practice provider and others, based on your needs. You also have access to experts like nutritionists, social workers, acupuncturists, psychiatrists and more who specialize in supporting people with cancer or blood disorders.

    Clinical trials

    For some people, taking part in a clinical trial may be the best treatment choice. Access to clinical trials by researchers at Fred Hutch and UW Medicine is one reason many patients come to us for care. 

    Our physicians and scientists are at the forefront of research to better prevent, diagnose and treat prostate cancer and to improve quality of life for survivors, including through the Institute for Prostate Cancer Research, a Fred Hutch–UW Medicine collaboration. 

    Clinical trial A type of research study that tests how well new medical approaches work in people. These studies test new methods of screening, prevention, diagnosis or treatment of a disease.

    Resources

    There are many resources online for learning about your disease, as well as organizations that provide community and support for your cancer diagnosis. Health educators at the Fred Hutch Patient and Family Resource Center have compiled a list of trusted sources to help you get started.

    Prevention and early detection

    Other than skin cancer, prostate cancer is the most common type of cancer in U.S. men. Early detection and improvements in therapy have resulted in a dramatic decrease in prostate cancer deaths (by 40 to 50 percent) since the early 1990s.

    One of the best ways to detect prostate cancer early is through screening — testing to find the disease in men with no prostate cancer symptoms

    Screening Checking for disease when there are no symptoms. Because screening may find diseases at an early stage, there may be a better chance of curing the disease Checking for disease when there are no symptoms. Because screening may find diseases at an early stage, there may be a better chance of curing the disease. Examples of cancer screening tests are the mammogram (for breast cancer), colonoscopy (for colon cancer) and Pap and HPV tests (for cervical cancer). Screening can also include a genetic test to check for a person’s risk of developing an inherited disease. Symptom A physical or mental problem that a person experiences that may indicate a disease or condition. Symptoms cannot be seen and do not show up on medical tests. A physical or mental problem that a person experiences that may indicate a disease or condition. Symptoms cannot be seen and do not show up on medical tests. Some examples of symptoms are headache, fatigue, nausea and pain.