Prostate Cancer Treatments

Clayton Lau Bio
Patients ... can rest assured that we have more experience than anyone else in the region for robotic surgery for straightforward and complex cases.
Clayton Lau, M.D.
Pauline & Martin Collins Family Chair in Urology

What Are the Treatment Options for Prostate Cancer?

Your prostate cancer is every bit as unique as you are, and that is why prostate cancer treatment at City of Hope is focused around you and your loved ones.

This means our physicians will personally consult with you about your disease, treatment options and desired outcomes. Afterward, our multidisciplinary team of specialists will work together to discuss, design and deliver an individual treatment plan to best meet those goals.

The innovative treatments we use to treat prostate cancer include:


Surgery — Prostatectomy

Surgery is the standard option for most prostate cancer patients, particularly in the early stages when cancer has not spread beyond the glands. Usually, our surgeons perform radical prostatectomy, which removes the prostate gland, seminal vesicles and surrounding tissues.

City of Hope is a leader in robotically-assisted prostatectomies, with decades of experience using the state-of-the-art da Vinci computer-enhanced minimally invasive surgery system. To preserve urinary and sexual function, our surgeons will avoid nearby nerves and blood vessels as much as possible. Sometimes, they may also remove and examine neighboring lymph nodes to determine if the cancer has spread.

Compared to an open surgical approach, robotic prostatectomies offer less pain, reduced scarring and faster healing time.

City of Hope also has an extensive recovery and follow-up program to help monitor and manage complications or side effects, restore urinary and sexual function and speedier return to the activities you love.


Radiation Therapy for Prostate Cancer

Radiation therapy uses high-energy X-rays or other forms of radiation to kill cancer cells. It may be delivered externally — using focused beams of energy — or internally, with a radiation-emitting substance placed in or near the tumor site. Depending on the prostate cancer type and the patient’s health and desired outcomes, treatment may include radiation therapy on its own or in conjunction with surgery and drug therapy. In addition, radiation can also be used to relieve prostate cancer symptoms. City of Hope offers a wide variety of leading-edge radiation therapy options to treat prostate cancer, including:

  • Image-guided external radiation systems, including TomoTherapy and TrueBeam: These systems combine detailed imaging and radiation delivery technologies, allowing our care team to “sculpt” radiation beams to the tumor site while avoiding nearby healthy tissue. This maximizes radiation’s prostate cancer-fighting ability while minimizing exposure to the bladder, rectum and nearby organs.
  • MRI-guided focused ultrasound: This nonradiation technology uses magnetic resonance imaging (MRI) to detail images of the prostate area, followed by a highly focused ultrasound to heat up and destroy cancerous tissue.
  • Brachytherapy: This therapy involves the placement of radioactive material next to or within the tumor site. Depending on the disease, patient health and treatment goals, the radioactive material may be low-dose-rate and permanently placed or high-dose-rate and placed for only a few minutes.

Patients also have access to our recovery program to address symptoms and issues that may arise from radiation therapy, such as urinary and sexual dysfunction.


Drug Therapy for Prostate Cancer

Drug therapy may be given to patients to fight prostate cancer cells throughout the body by killing them or stopping their growth and spread. These drugs include:

  • Hormone therapy: blocks the production or activity of hormones — particularly testosterone and dihydrotestosterone (DHT) — which fuels most prostate cancer growth
  • Chemotherapy: targets all rapidly dividing cells, including prostate cancer cells
  • Targeted therapy: selectively attacks prostate cancer cells based on specific characteristics, such as a gene mutation
  • Immunotherapy: stimulates the patient’s immune system to attack cancer cells

Your doctor may also prescribe drugs to treat conditions related to prostate cancer, such as weakened bones and sexual dysfunction — common side effects of hormone therapy — or bone loss from metastasized prostate cancer. The drug or drug combination used depends on the prostate cancer type and stage, previous treatments used, and the patient’s health and overall treatment goals. Molecular or genetic testing can further enhance this personalized medicine approach. Testing can identify more effective treatments that cause fewer side effects.

City of Hope has a broad portfolio of cancer-fighting drugs available in its on-site pharmacy, allowing our medical oncologists to plan and prescribe a drug regimen that can best fight prostate cancer while minimizing side effects. In addition to standard drug treatments, patients may also be eligible for new, promising drugs through our clinical trials program.


Active Surveillance

For men with early-stage, slow-growing prostate cancer, active surveillance may be considered an option since the benefit of immediate treatment may not outweigh its risk. This approach includes regular monitoring of prostate-specific antigen, or PSA, levels and digital rectal examinations of the prostate. Then, as soon as abnormalities arise or symptoms begin to display, the doctor and patient can opt for treatment. When performed regularly and on schedule, active surveillance typically catches prostate cancer in its earliest stages of progression, when it is still very treatable with surgery, radiation or drug therapy.