Prostate Cancer Treatment

Prostate cancer typically grows slowly. This means that some patients do not need any treatment. It you have low-risk prostate cancer, meaning it is not aggressive and is unlikely to impact your life expectancy and quality of life, close monitoring may be your best choice. 

Active surveillance involves regular follow-up visits with your care team, as well as PSA tests, digital rectal exams and a repeat biopsy every year, or more often if needed. During surveillance, if your care team detects the cancer is becoming more aggressive, you may then consider treatment.

Prostatectomy is the removal of all or part of the prostate. Radical prostatectomy is commonly performed for men with early-stage prostate cancer. In this procedure, the entire prostate and surrounding tissue are removed.

There are two common types of prostatectomy:

• In open prostatectomy, your surgeon removes the prostate through a large incision in your lower abdomen.
• In laparoscopic prostatectomy, the prostate is removed through several small cuts, and the surgeon is guided by a tiny camera. Your surgeon may use a robotic system that offers a higher level of precision. Laparoscopic surgery typically results in less bleeding, faster recovery and a shorter hospital stay compared to open surgery. It also carries a lower risk of complications with bowel and bladder function after surgery.*

Prostatectomy carries some risks:

• Difficulty controlling urine or bowel movements
• Difficulty getting or keeping an erection
• Injury to the rectum
• Narrowing of the urethra

There may be other risks, depending on the specific medical condition. Be sure to discuss any concerns you may have with your doctor before the procedure.

*Source: Cao, Lan MD^a; Yang, Zhenyu MD^b; Qi, Lin MD^b; Chen, Minfeng MD^b,* Robot-assisted and laparoscopic vs open radical prostatectomy in clinically localized prostate cancer, Medicine: May 2019 - Volume 98 - Issue 22 - p e15770 doi: 10.1097/MD.0000000000015770

Radiation therapy can be used as a first-line treatment for prostate cancer or it may be an option if your cancer has spread or recurred. During radiation therapy, radiation is directed at your cancer to kill or stop the growth of cancer cells. Our radiation therapists will plan your course of treatment according to your needs, considering the stage of your cancer and your medical history.

Northwestern Medicine uses the SpaceOAR^® hydrogel system to reduce the risk of injury to the rectum during radiation therapy. This system pushes the rectum away from the prostate during treatment, reducing its radiation exposure.

Northwestern Medicine also offers proton therapy, which is a precise type of radiation therapy that specifically targets tumors. Scientists at Northwestern Medicine Proton Center offer compelling evidence that proton therapy may be a better option. This therapy may reduce damage to surrounding healthy tissues, reducing the impact on the bladder and rectum.

Brachytherapy is a treatment that delivers radiation internally. Tiny radioactive seeds are inserted in your body and remain there, delivering a higher dose of radiation directly to cancer cells.

Prostate cancer cells need testosterone to grow. Through hormone therapy, your care team can reduce the amount of testosterone in your body or prevent the hormone from working. This type of therapy is commonly used to treat cancer that has spread beyond the prostate or for a recurrent cancer. 

Chemotherapy is a medication that helps stop the growth and spread of cancer cells. This is a treatment option if your prostate cancer has spread outside the prostate or if it has not responded to hormone therapy. Chemotherapy may be given either through an IV (in the vein) or taken orally. ding. 

A genomic test detects and measures subtle genetic changes in your tumor generating information that can help physicians determine how best to treat your disease. Collaboration between genetic counselors and oncologists applies precision medicine to the management of inherited prostate cancer. Based on the principle that each individual prostate cancer is unique, our patient-centered genomics research program offers personalized evaluations and customized treatment plans for newly diagnosed prostate cancer patients. Genetic testing will be done on prostate tumors extracted during surgery to determine the genetic composition of the tumor. All tumors will undergo genomic sequencing and molecular analysis with standard pathology to develop a personalized treatment plan based on the tumor’s unique genomic profile. A world-class team of medical, surgical and radiation oncologists, molecular pathologists, radiologists and pharmacogenomics specialists will collaborate to develop a personalized plan with a targeted therapy or new treatment being studied in a clinical trial. 

At Northwestern Medicine, we are in relentless pursuit of better medicine. That means our physician-scientists are continually working to advance the understanding and treatment of disease. We offer leading-edge treatments, such as immunotherapy, and access to clinical trials.

Immunotherapy harnesses your own immune system to fight cancer. To achieve this, special cells in your body are recruited and modified for this purpose, or cells are created in a laboratory and injected into your blood stream to help your body fight the cancer.

Clinical trials help scientists determine if new treatments are safe and effective, and if they work better than conventional treatments. Patients who participate in clinical trials help advance our understanding of cancer and help chart the future of medical care. In fact, many of today’s cancer treatments grew out of previous clinical trials.

If you participate in a clinical trial, you may be given the new treatment that is being tested or the standard treatment for comparison.

A variety of clinical trials are typically available depending on where you are in your cancer journey. Trials are offered for patients who:

• Have not started treatment
• Have had previous treatment that has failed
• Have previously had cancer, to test ways to stop it from recurring
• Are undergoing treatment, to test ways to reduce side effects

Browse our Clinical Trials to learn more about ongoing trials.