Houston Methodist. Leading Medicine.
Houston Methodist. Leading Medicine

Treating Prostate Cancer

Treating Prostate Cancer

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Once prostate cancer has been diagnosed, your doctor may recommend one or more of the following treatments.

Active Surveillance
Radiation Therapy

Active Surveillance
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 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 faster. If it appears to be growing, your doctor would then talk to you about treatment options.

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 (radical retropubic prostatectomy) or in the skin between the anus and the scrotum (radical perineal prostatectomy). Today more and more surgeons are performing this procedure laparoscopically, which involves smaller cuts, the use of special long surgical tools, and sometimes a robotic interface.

Houston Methodist performs robotic-assisted prostatectomies using the da Vinci® Surgical System.

Two other surgical approaches to prostate cancer are:

  • 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 of the cancer, but it can remove enough to restore the flow of urine.

Radiation Therapy
Radiation therapy uses high-energy rays to kill cancer cells in a specific area. It may be used:

  • 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 afterwards, or
  • 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 each and usually occur 5 days a week for about 7–9 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.

Hormone Therapy
Hormone therapy may be prescribed along with radiation treatment or by itself if the cancer returns after it has been treated.

Hormone therapy prevents prostate cancer cells from getting the male hormones (androgens) they need to grow. The treatment involves either drugs to block natural hormones or surgery to remove the testicles (orchiectomy).

Chemotherapy treats prostate cancer using drugs administered through an 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. Chemo 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 prostate cancer:

For more information about prostate cancer treatment at the Methodist Cancer Center or to make an appointment, call us at 713-790-2700.