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Prostate cancer

Also known as: Cancer, prostate

Many effective treatments are available

Overview:
Prostate cancer is the abnormal growth of cells in the tissues of a man’s prostate gland. The prostate gland is a walnut-shaped organ below a man's bladder that creates fluid for semen.

About 1 in 6 men will develop prostate cancer in his lifetime, and it’s most common in men older than 65. It’s the most common type of cancer in American men. The good news is the disease is very manageable and often can be cured. More than 99 percent of men with prostate cancer will live more than five years after being diagnosed.

Symptoms include:

  • Problems when you urinate, such as:
    • Not being able to urinate
    • Having a hard time starting or stopping the flow of urine
    • Having to urinate often, especially at night
    • Having pain or burning during urination
  • Difficulty having an erection
  • Blood in your urine or semen
  • Deep and frequent pain in your lower back, belly, hip or pelvis

How to treat prostate cancer:
Providence Cancer Institute offers a wide range of treatment options for patients with prostate cancer, including different types of radiation therapy and surgery. Your doctor also may recommend “watchful waiting,” which means you visit the doctor regularly to monitor your prostate cancer and see if you need treatment. Please discuss these options with your doctor to determine what will work best for you.

Radiation therapy

We offer the latest types of radiation treatments for men with prostate cancer. This includes therapies that involve higher doses of radiation, such as “external beam radiotherapy” and “brachytherapy.” Higher doses of radiation therapy have been shown to improve patients’ chances of being completely cured. Traditional lower dose treatments also are available.

External beam radiotherapy

This involves high doses of radiation given daily, usually over seven to nine weeks, and focuses radiation beams on the prostate. Specific types of external beam radiotherapy include:

  • Volumetric modulated arc radiotherapy (VMAT) that delivers quick external beam treatments over a few minutes each weekday for several weeks. X-rays are done daily to make sure the target is accurate and that nearby normal tissue isn’t affected.
  • Hypofractionated radiotherapy increases the radiation dose per day and is best for certain types of patients. Treatments usually last four to six weeks.

Brachytherapy

This type of treatment also involves high doses of radiation and treats the cancer by placing radioactive material directly into the prostate. Depending on your situation, brachytherapy may be used alone, combined with external beam radiotherapy, and/or hormone therapy. Radiation dose from brachytherapy can be delivered at different rates – both low-dose-rate (LDR) or high-dose-rate (HDR).

Temporary high-dose rate (HDR) brachytherapy

This is a new and highly effective type of brachytherapy treatment. Recent studies have shown that the HDR technique improves cure rates for prostate cancer while also sparing nearby normal tissue. A single small radioactive dose is placed in a narrow tube called a catheter. The catheter is then placed into the prostate by your radiation oncologist. You will be under anesthesia and will not feel pain. Special computer software controls where and for how long the radiation is delivered. This helps target the prostate cancer very precisely. The catheter is then removed. Once the treatment is complete, there is no radioactivity left in your body and there is no need for radiation safety precautions. You usually can go home shortly after the procedure, and you can continue your normal activities with few restrictions.

Low-dose rate (LDR) permanent seed implant

This treatment has been used for many years for some men with prostate cancer. Permanent small metal “seeds” are inserted directly into the prostate gland. The seeds are temporarily radioactive and send radiation to the prostate over several months. During the first two or three months after the implant, men are asked to limit close contact with children and pregnant women. After two to three months, the seeds lose their radioactivity and are then harmless.

Surgery

Surgery is a common choice to try to cure prostate cancer if it hasn’t spread outside the prostate gland.

The main type of surgery for prostate cancer is called a radical prostatectomy. The surgeon removes the entire prostate gland plus some of the tissue around it, including the seminal vesicles, which create most of the fluid found in semen.

Chemotherapy

Chemotherapy is the use of medications to kill cancer cells. Different chemotherapy medications destroy cancer cells by a variety of different mechanisms. Many work on the DNA of a cell to prevent it from reproducing, while others deprive cancer cells of what they need to grow. Learn more › 

Hormone therapy

Hormones control the growth and activity of body cells. Most prostate cancers depend on testosterone, the major male hormone, to grow. Hormone therapy removes hormones or blocks their action and stops cancer cells from growing. The testosterone levels can be reduced either by surgery (bilateral orchiectomy) or drugs.