Types of Prostate Cancer Treatment at MedStar Georgetown Cancer Institute
Unlike other cancers, prostate cancer offers a wide range of effective and safe treatment options. Our doctors tailor prostate cancer treatment to your particular needs and conditions, including:
- General health
- Size of the initial tumor
- Whether the cancer has spread
If you’re older and have a lower-risk case, we may recommend active surveillance, or watchful waiting — regularly monitoring your prostate for further change but taking no further steps. Doing so can avoid the possible side effects of prostate cancer treatment.
For many men under 65, surgery to remove the prostate — a prostatectomy — is often the best answer. That’s especially true if the cancer is:
- Confined to the prostate (localized): Studies show that surgery provides the best results for these men, with most patients remaining cancer-free 15 to 20 years later. Some lymph nodes may also need to be removed (pelvic lymphadenectomy), and we may recommend radiation after surgery.
- Minimally Invasive Surgery: Minimally invasive techniques offer benefits over conventional open surgery and are typically performed robotically with our da Vinci Surgical System. Our program features the region’s most experienced robot-assisted surgeon.
Prostate CyberKnife Therapy
When prostate removal is not possible and the tumor is still in an early-stage and confined, our doctors often turn to CyberKnife — a sophisticated system for delivering targeted radiation with laser-like precision. As an early adopter, our experience with CyberKnife for prostate cancer treatment is among the highest in the world. The system offers a number of benefits:
- Minimal pain
- Less damage to surrounding tissues
- Accurate delivery of the high-dose radiation shown to improve outcomes
- Minimally invasive
- Little or no recovery time
- Only five treatments instead of 40
- Fewer side effects
- Fast, convenient and effective
Despite its proven effectiveness, we continue to study the system for further advances — one of the few centers in the country to do so.
Other Radiation Therapies
In addition to CyberKnife, we offer other state-of- the-art radiation therapies:
- Image-Guided Radiation Therapy (IGRT) and RapidArc: Imaging technology guides the cancer cell-killing radiation delivered after some surgeries, while the RapidArc system safely delivers a high dose in one continuous 360-degree sweep around the body. The speed and precision provide unlimited options for designing more sophisticated and refined treatment plans for each patient, meaning fewer side effects and less damage to healthy tissue.
- Brachytherapy: Tiny, radioactive “seeds” (titanium capsules) are carefully and strategically placed near the tumor, providing radiation therapy for about three months. We offer both low- and high-dose brachytherapy.
Cryotherapy is also a good treatment option for some men. Also called cryosurgery or cryoablation, the minimally invasive procedure freezes and destroys cancer cells with a special probe.
Cryotherapy is an effective treatment for men who:
- Are in the early stages of prostate cancer, with low risk for continued tumor growth
- Are not good candidates for surgery
- Have tried external radiation therapy without good results
- Have been told their cancerous cells are resistant to radiation
For many years, doctors suspected that prostate cancer resisted chemotherapy. However, we now offer drugs such as Taxotere and Jevtana that can prolong survival by causing the cancer to regress.
Targeted therapy provides the potential for more powerful and less toxic approaches to fighting cancer. Also called immunotherapy or biological therapy, targeted therapy starts with the identification of a cancer’s particular characteristics, then uses drugs or other substances to trigger the body’s own immune system, respond to genetic changes or interfere with the way cancer cells operate.
For prostate cancer, immunotherapy vaccine Provenge prompts a patient’s own white blood cells to destroy cancer, prolonging survival for men with advanced disease. This new class of therapies could change the way prostate cancer is treated, and we participated in the clinical trials that led to its approval and use.
Prostate cancer requires male hormones (androgens) to grow, mainly testosterone. That means drugs that block testosterone production or stop it from working are a prostate cancer treatment option for many men, particularly if the cancer is advanced, has spread (metastasized) to other tissues and organs or has returned (recurred) after surgery and radiation.
While not a cure, hormone therapy can stop or reverse the cancer’s progression, and relieve symptoms. The drugs’ effects are also reversible, unlike surgery to remove the testicles — another option. If initial hormone therapy doesn’t work, we now have oral therapies such as Zytiga and Xtandi, as well as radium-223 (Xofigo).