In recent years, medical researchers have discovered more effective ways to treat prostate cancer than ever before.
That is especially true at City of Hope. As one of the world’s leading cancer treatment facilities, we have a staff of highly respected physicians trained in the most advanced techniques.
- Robotic-assisted prostatectomy (da Vinci S Surgical System)
- Radiation therapy, including TomoTherapy, brachytherapy and intensity-modulated radiation therapy
- Innovative chemotherapy and clinical trials of leading-edge treatments
State-of-the-art robotic-assisted surgery
City of Hope was one of the first cancer centers in the country to adopt this amazingly precise, minimally invasive surgical technology. The procedure requires five tiny incisions. First, a pencil-thin laparoscope (a lighted tube with a video camera) is inserted, so live images can be transmitted to a computer. Through the remaining incisions, four slender robotic arms with miniature surgical instruments go to the surgical site. The surgeon sits at a nearby console, viewing the procedure while using grippers to remotely control the tiny tools.
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. Less surgical trauma means less risk of side effects for our patients.
Patients who undergo robotic surgery experience less pain and recover faster. Typically, recovery from conventional surgery takes three to four days in the hospital, and up to six weeks at home. With robotic-assisted surgery, the hospital stay is reduced to one or two days. Recovery time is only two to three weeks — less than half as long as traditional surgery.
With smaller incisions, patients also experience less blood loss. This helps reduce the need for transfusions, keeps blood pressure stable, and lowers the risk of complications. Patients typically emerge from surgery stronger, and can get back to normal life sooner.
Finally, because robotic-assisted surgery does not require a large abdominal incision, there’s less pain and less need for pain medicine. Most patients are on their feet within hours of surgery.
Advanced Radiation Therapies
Combining three-dimensional imaging with intensity-modulated radiation therapy technology, TomoTherapy bombards the tumor from all directions with hundreds of pencil-thin energy beamlets. The radiation matches the contours of the tumor precisely, delivering the optimal dose while avoiding normal tissues nearby. With less unwanted exposure, TomoTherapy offers better results, reduced risk of complications and fewer side effects.
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.
Any radiation treatment affecting the pelvic region can cause difficulties with urination, bowel problems and sexual side effects such as erectile dysfunction. These are often temporary, and can usually be treated with medication or other strategies if necessary.
Other Treament Options
Male hormones called androgens help the prostate develop normally during adolescence. But as time goes on, these hormones can promote the growth and spread of prostate cancer. By lowering androgen levels in your body, those same cancers can be made to shrink, or at least grow more slowly. While not a cure, hormonal therapy can put the cancer in a kind of “hibernation” for many years.
There are three kinds of hormonal therapy:
- Drugs that block your body’s ability to use androgens, they are often used in conjunction with the two methods described below.
- Drugs that decrease the production of androgens, they are injected either monthly or every four months, depending on which medication is used.
- This is surgery to remove the testicles, where most of the body’s androgen is produced.
Chemotherapy – the use of anticancer medicines – includes a wide range of drugs and treatment strategies to treat prostate cancer. City of Hope provides both standard chemotherapies as well as access to newly developed drugs through an extensive program of clinical trials.
As part of the treatment team, a medical oncologist will evaluate the best options, so that a course of chemotherapy, if appropriate, can be tailored to the patient.
Erectile dysfunction and loss of bladder control are potential — most often temporary — side effects of prostate gland removal. At City of Hope, patients report a 70 percent continence rate six months after surgery. Regaining sexual potency depends on the extent of your surgery, and how functional you were before the operation. Most men find that their erections return a week to 18 months after their surgery. Medications may be used to assist with recovery.
Many men find City of Hope’s Prostate Support Group helpful, as well as our Continence Recovery Program and assistance for potency recovery.
