Treatment & Procedures
The treatment your doctors recommend is based on information about the type of tumor you have and how far it has spread, which is reflected in the “stage” of the tumor. Stage 1 is used to characterize disease confined to the involved organ and stage 4 indicates cancer that has spread from the affected organ to other parts of the body.
The Gleason score is another important factor in prognosis and treatment selection for prostate cancer. The Gleason score is based on a pathologist’s examination of a biopsy specimen under a microscope. By looking at the tumor sample, the pathologist can assign a grade to the tumor: tumors that have a normal appearance are grade 1, whereas those that appear most abnormal are grade 5. More aggressive tumors have higher Gleason scores.
Depending on your symptoms, your doctor may order additional tests, such as a bone scan, to see if there are cancer cells in your bones.
If prostate cancer is diagnosed at an early stage and appears to be growing slowly, and if the possible side effects of treatment outweigh the benefits, your doctor may recommend active surveillance. This involves monitoring the tumor closely through prostate-specific antigen (PSA) tests, digital rectal exams and ultrasounds at regular intervals to see if it grows. Prostate biopsies may be done as well to see if the cancer is growing. If it appears to be growing, your doctor will then talk to you about treatment options.
Male sex hormones (androgens) stimulate the growth of prostate tumors. One systemic approach to treating prostate cancer is hormone therapy. This type of treatment slows tumor growth by inhibiting the production of androgens, blocking their action or both. Click here to see more extensive general information on hormone therapy, including how it works and how it may affect you.
Surgery for Prostate Cancer
The main type of surgery for prostate cancer is known as a radical prostatectomy, in which the surgeon removes the entire prostate gland plus some of the tissue around it.
The traditional approach to radical prostatectomy involves making a long incision, either in the lower abdomen or in the skin between the anus and the scrotum. Today, more and more surgeons are performing this procedure laparoscopically. Laparoscopic surgery uses a camera mounted on a thin flexible tube and special long surgical tools; sometimes a robotic interface is used. This minimally invasive surgery involves smaller incisions and usually shorter recovery times.
At Houston Methodist, we perform robotic-assisted prostatectomies using the da Vinci® Surgical System.
There are two other surgical approaches to prostate cancer:
- Cryosurgery: The surgeon makes a small cut between the scrotum and anus and inserts a tool that freezes and kills prostate tissue. This approach is still under study.
- Transurethral Resection of the Prostate (TURP): This may be performed to relieve symptoms in patients with advanced prostate cancer. The surgeon inserts a long, thin scope through the urethra, and a cutting tool at the end of the scope removes prostate tissue. TURP may not remove all the cancer, but it can remove enough to restore the flow of urine.
Learn more about surgery, including the roles different surgical approaches have in in preventing, diagnosing and treating cancer.
Radiation Therapy for Prostate Cancer
Radiation therapy uses high-energy rays to kill cancer cells in a specific area. There are several different scenarios that may prompt your doctor to use radiation:
- As initial treatment for low-grade cancer that is confined to the prostate gland
- As part of initial treatment, along with hormone therapy, for cancer that has grown outside of the prostate
- If the cancer is not completely removed in surgery or comes back afterward
- If the cancer is advanced, to reduce the size of the tumor and provide relief from symptoms
There are two main types of radiation therapy available to treat prostate cancer:
- External radiation therapy: A large machine directs radiation rays at your prostate. Sessions take only a few minutes and usually occur five days a week for about seven to nine weeks.
- Internal radiation therapy (also called brachytherapy): Your doctor places a small source of radioactive material (usually in the form of seeds) directly into the tumor.
Learn more about the variety of innovative radiation therapies offered at Houston Methodist.
Chemotherapy for Prostate Cancer
Chemotherapy treats prostate cancer using drugs administered through an intravenous (IV) line or orally. It may be used if the cancer has spread and does not respond to hormone therapy. You may receive your treatments in a clinic, at the doctor’s office, or if oral chemotherapy is prescribed, at home. Chemotherapy is given in cycles, with each round of treatment followed by a rest period. The side effects depend mainly on the type and amount of drugs you receive.
Learn more about chemotherapy treatment, including how it works within your body and what to expect while undergoing treatment.
Our continued commitment to research enables us to improve present and future cancer care. Learn more about our current cancer-related clinical trials.
Our physicians specialize in managing prostate cancer at the following convenient Houston Methodist Cancer Center locations.