Prostate Cancer Treatment Approaches
Just as every patient is different, we recognize that every case of prostate cancer is different. What distinguishes City of Hope is the experience and coordination within our care team, which optimize outcomes and ensure continuity of care from diagnosis through treatment to recovery and follow-up.
Additionally, City of Hope offers innovative treatments not available elsewhere, including:
- Robotic-assisted prostatectomy using the da Vinci S™ Surgical System)
- Radiation therapy, including TomoTherapy, brachytherapy and intensity-modulated radiation therapy
- Novel hormone therapy and chemotherapy regimens through our prostate cancer clinical trials
Our patients are provided treatments based on the latest evidence available and up-to-date clinical guidelines. Factors that determine the therapy regimen include:
- Type and risk level of disease
- Prior therapies, if any
- Patient’s characteristics, such as age and overall health
- Choice of the patient and care provider, if multiple treatment options are available
Based on these factors, the prostate cancer treatment regimen may include one or more of the following:
City of Hope was one of the first cancer centers in the country to adopt precise,
minimally invasive, robotically-assisted surgical technology
using the da Vinci S™ Surgical system. This procedure requires only five tiny incisions, allowing for visualization and use of miniature surgical equipment, which are controlled remotely by a surgeon at a nearby console.
Because the robotic arms can rotate 360 degrees, these instruments can move with a full range of motion as they cut and suture with great precision. A highly magnified real-time three-dimensional image helps the surgeon avoid delicate nerves and muscles surrounding the prostate.
Because robotic-assisted surgery does not require a large abdominal incision, it lowers risk of side effects to our patients, such as blood loss and pain. Most patients are on their feet within hours of surgery and can get back to a normal life sooner.
uses high-energy X-rays or other types of radiation to kill cancer cells or keep them from growing. Depending on the type and stage of prostate cancer, our patients may be given one of the following radiation treatments:
Helical TomoTherapy: City of Hope is the first center in the western United States to offer
which combines radiation delivery with real-time imaging, allowing doctors to deliver a higher dose of radiation with greater precision. This significantly improves outcomes and reduces side effects by minimizing radiation exposure in nearby normal tissues.
Brachytherapy: In this procedure, tiny pellets of radioactive material smaller than a grain of rice are inserted directly into the cancerous tissue. The radiation attacks the tumor from the inside out. By directly targeting cancer, brachytherapy minimizes radiation to healthy tissue. In most cases, complications are few, and recovery is relatively rapid.
Chemotherapy, or the use of cancer-fighting drugs, may be used in treating prostate cancer, particularly those who have recurrent or advanced disease. Chemotherapy is usually given in cycles, with breaks in between to allow patients to recover from side effects. At City of Hope, our expert team of medical oncologists will assess each patient’s case, evaluate the different drug therapies available and tailor the most appropriate and effective regimen against the disease for optimal outcomes.
In addition to FDA-approved drugs for prostate cancer
, City of Hope researchers and clinicians are constantly developing new regimens to improve the effectiveness of existing drugs or building new drugs that are more powerful against prostate cancer.
Because male hormones can promote the growth and spread of some prostate cancers, hormone therapy may be used to help shrink or slow the growth of the disease. Though it is not considered a cure, hormone therapy can put the cancer “in hibernation” for many years.
Hormone therapy may involve use of drugs that block androgen production, drugs that inhibit the body’s ability to process and use androgen or orchiectomy (surgical removal of testicles — where most of the body’s androgens are produced).
There has been some debate about the value of regular prostate-cancer screening (prostate-specific antigen, or PSA, test), especially in men who have been diagnosed with prostate cancer. Many prostate cancers do not require immediate treatment because they are small, confined and slow growing.
Aggressive treatment may be more disruptive to a man’s quality of life than "active surveillance," which closely monitors patients to detect early signs of disease progression and enables treatment before the cancer has spread beyond the prostate.
For those men with low-grade tumors, City of Hope specialists may recommend active surveillance. Our specialists will determine the best course of treatment balanced with each man’s vision of a quality life beyond diagnosis.
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