Prostate Cancer Treatments

Receiving a diagnosis of prostate cancer isn’t easy, but the good news is that it can be successfully treated, particularly when it’s found early. 

At UT Southwestern Medical Center, if a patient is diagnosed with prostate cancer, our physicians will develop a unique plan of care. Because the disease usually grows slowly, immediate treatment might not be necessary. However, we will actively monitor the situation with the appropriate tests at regular intervals, depending on the situation, watching for changes.

For those patients who do require treatment, we offer the following advanced techniques. 

Treatment With Medications

Medical treatment involves the use of drugs to kill cancer cells or help prevent them from spreading. Options include:

• Chemotherapy: A wide range of anti-cancer medications can be used with patients whose prostate cancer has metastasized outside the prostate.
• Drugs to prevent the spread of cancer to the bones: Bisphosphonates and radiopharmaceuticals are two types of drugs that specifically target bone metastasis.
• Hormone therapy: New studies indicate that men whose prostates are removed to treat prostate cancer are likely to survive longer if they take drugs to block the male hormone testosterone in addition to undergoing radiation therapy.
• Immunotherapy: Sipuleucel-T is an immunotherapeutic vaccine that boosts the immune system to help it attack prostate cancer cells. 

Radiation Therapy

Radiation therapy uses radiation to kill cancerous cells. UT Southwestern has one of the most advanced radiation therapy programs in the country for the treatment of prostate cancer. 

Our physicians pioneered the five-treatment stereotactic radiation regimen for early- and intermediate-risk prostate cancer, and this regimen is now being adopted at many progressive centers worldwide. 

We offer the following advanced radiation therapy techniques for prostate cancer. 

Stereotactic Body Radiation Therapy (SBRT)

UT Southwestern has been leading efforts to explore the safety and efficacy of SBRT for more than a decade. Most recently, a study published by our researchers shows that SBRT offers a higher cure rate for cancer than more traditional approaches. That study – the first trial to publish five-year results from SBRT treatment for prostate cancer – found a 98.6 percent cure rate with SBRT among 91 patients.

SBRT uses advanced image guidance to very precisely deliver radiation from many different angles. While each beam is relatively weak on entry, the dose at the convergence point is enough to kill a tumor in just five treatments versus 45 or more treatments with standard therapy. To make the SBRT treatments safer, current clinical trials at UT Southwestern are using a biodegradable rectal spacer gel to protect the rectum. We are currently the only accredited site in Texas at which this spacer gel can be used. 

Currently, SBRT is being evaluated here for the treatment of patients with high-risk prostate cancer as well. 

Intensity-Modulated Radiation Therapy (IMRT)

For patients who are not candidates for stereotactic therapy, intensity-modulated radiation therapy (IMRT) is a state-of-the-art technology that is used to treat difficult-to-reach tumors such as prostate cancer.

IMRT is delivered using multiple beams of radiation that conform the dose in three dimensions to match the exact shape of the target. IMRT can also modulate the intensity of the dose, meaning that a higher dose can be given to the tumor target while lower doses can be used to spare normal tissue or sensitive structures. 

Brachytherapy (Seed Implants)

Another available option is brachytherapy, in which radioactive seeds are implanted in the prostate to deliver radiation and treat cancer from within. The permanent seeds, which lose their radioactivity at a predetermined rate after several weeks, are implanted by needle under anesthesia in an outpatient procedure room.

A dedicated brachytherapy specialist with advanced training in placing these implants performs these procedures. Brachytherapy is able to achieve a very conformal dose in most instances, meaning the radiation stays within the defined target with no entry radiation and very little spillover into surrounding normal tissue.

Surgery

A radical prostatectomy is a surgical procedure to remove the prostate. We offer this minimally invasive procedure with or without the use of a surgical robot.