Prostate Cancer Treatment

While prostate cancer is the second-leading cancer among men after non-melanoma skin cancer, most types of this disease can be treated and cured. This is especially true in cases where the cancer is localized, meaning it has not spread to any surrounding areas.

Winship’s renowned prostate cancer and genitourinary cancer teams work together to provide the most appropriate, individualized approach to treating prostate cancer patients. They include urologists, medical oncologists, radiation oncologists, interventional radiologists, nuclear medicine specialists, advanced practice nurses, pathologists, pharmacists and social workers.

Winship’s weekly tumor board reviews each prostate cancer case. It’s part of our thorough, multidisciplinary review process that takes every factor into account — including the size and location of the tumor, whether the cancer has spread and the patient’s overall health — to provide the best prostate cancer treatment options. This plan will then be recommended to you, and next steps can be taken in your treatment.

Throughout the process, you'll have access to a nurse navigator who can help schedule appointments, answer any questions you may have, help minimize potential treatment side effects and provide support.

There are multiple treatment approaches when it comes to prostate cancer. Winship patients work with their dedicated health care team to understand all options and select the one that best fits their situation.

One or more of the following types of treatment may be used:

Active Surveillance

This approach involves monitoring the cancer until you and your health care team determine the time to take action. While waiting to treat the cancer, each Winship patient is followed very closely and receives regular screenings, tests and follow-up care. This treatment plan is mostly used for those with low-risk, slow-growing prostate cancer as well as older patients with health problems, where the risk of treatment outweighs the benefits.

Surgery

Surgery is a highly  effective form of prostate cancer treatment. The procedure for removing the prostate is called a radical prostatectomy. Radical prostatectomies are the most commonly used surgical technique for prostate cancer. During this procedure, the surgeon removes the entire prostate, including surrounding tissue and the seminal vesicles. If necessary, surrounding lymph nodes within the pelvis will be removed as well.

At Winship, surgeons most often use a minimally invasive approach. Robotic prostatectomy has become the most common way radical prostatectomies are performed. Compared with traditional open surgery, the da Vinci robotic system uses specialized instruments that bend and rotate far greater than the human hand. Robotic prostatectomies have led to far fewer complications, lower rates of post-surgery infections and shorter recovery times.

Radiation Therapy

Radiation therapy consists of targeting high-energy particles or waves at cancer cells or tumors. Radiation therapy is done both to relieve symptoms and, in some cases, cure prostate cancer entirely. The radiation therapies currently used to treat prostate cancer include external beam radiation therapy (EBRT or EBT), brachytherapy (internal radiation therapy), proton beam radiation, three-dimensional conformal radiation therapy (3D-CRT) and intensity-modulated radiation therapy. The type that is best suited for each individual’s cancer varies and our radiation oncology team determines it on a case-by-case basis.

Proton Therapy

Winship is the only cancer center in Georgia, and one of a select group in the entire United States, to offer proton therapy, a powerful and precise form of radiation therapy used to treat prostate cancer in some patients. Proton therapy delivers a high dose of radiation to a tumor while avoiding damage to surrounding healthy tissue.

Hormone Therapy

Hormone therapy, also called androgen deprivation therapy, reduces the number of male hormones so that the prostate cancer cells stop growing. Several novel hormonal agents such as abiraterone and enzalutamide may be used to disrupt oncogenic pathways if surgery or radiation is not an option or in conjunction with other therapies.

Focal Therapy

Focal therapy for prostate cancer is a minimally invasive treatment that targets and destroys only the cancerous areas within the prostate, preserving as much of the healthy tissue as possible. This approach aims to reduce side effects and maintain quality of life while effectively treating the cancer. Common focal therapy techniques include cryotherapy (or freezing the cancer cells), high-intensity focused ultrasound and laser ablation.

Interventional Radiology

This technique uses imaging to guide minimally invasive non-surgical procedures, such as laser ablation to treat prostate cancer, or prostate artery embolization to treat benign prostate hyperplasia, a non-cancerous enlargement of the prostate.

Nuclear Medicine

Nuclear medicine uses radiotracers or radioactive drug therapies to diagnose, evaluate and treat various diseases, including prostate cancer. Winship specialists have pioneered the use of fluciclovine in combination with PET imaging to better plan treatment decisions for patients with recurrent prostate cancer.

Chemotherapy

Chemotherapy is sometimes considered if prostate cancer has spread outside the prostate gland and hormone therapy is no longer effective.

In addition to standard therapies, participating in clinical trials may be an option for you. Clinical trials provide patients with access to new medications and therapies that are being developed for prostate cancer treatment. As Georgia’s only NCI-designated Comprehensive Cancer Center, Winship offers patients the latest clinical trials being done to treat prostate cancer today.

At Winship, each patient is carefully considered to see whether they qualify for a clinical trial using innovative treatment methods.

With prostate cancer, some side effects can last for a period of time during and after treatment and then go away. Others are more long-lasting and permanent. Urinary incontinence and erectile dysfunction are two possible side effects.

Some men may experience sexual changes after treatment for prostate cancer. Winship experts worked with colleagues from other institutions to create an online, tailored interactive program to support men and their partners on their journey toward sexual recovery after prostate cancer treatment.

We recognize that urinary incontinence and erectile dysfunction can be important factors in prostate cancer survivorship. Our team of urology experts offers multiple options to help you manage these conditions.

In addition to the advanced care and treatment methods, Winship also offers a supportive oncology team of specialized doctors and nurses who can help with the physical, psychological and emotional aspects of living with cancer, including symptom management and counseling. We know that a cancer diagnosis is scary and stressful. That’s why Winship’s counselors, nurse navigators, dietitians and social service professionals are with you every step of the way.