Prostate cancer is a prevalent concern among men in the United States, ranking as the second most common cancer, particularly for those over the age of 50. It’s crucial to understand that while many men may be diagnosed with prostate cancer during their lifetime, the majority experience slow-growing forms that pose no immediate threat to their health. In fact, many individuals diagnosed with prostate cancer will live long lives and ultimately succumb to other causes, rather than prostate cancer itself.
The prostate gland, a small but significant organ, is located beneath the bladder and at the base of the penis. Its strategic positioning means that any prostate-related health issues, whether cancerous or benign, can potentially impact both urinary and sexual functions. Notably, the nerves and blood vessels responsible for erectile function are situated in close proximity to the prostate, making them vulnerable to the effects of prostate cancer and its treatments.
In over 90% of diagnosed prostate cancer cases, the cancer remains localized within the prostate gland. However, prostate cancer can spread beyond the prostate capsule, its protective outer layer. It may extend upwards into the seminal vesicles, two small, tube-like glands situated atop the prostate. In some instances, prostate cancer can metastasize to the pelvic lymph nodes or bones.
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Comprehensive Prostate Cancer Treatment Options
For individuals diagnosed with slow-growing prostate cancer, active surveillance is often a recommended approach at Memorial Sloan Kettering Cancer Center (MSKCC). Certain prostate cancers exhibit such slow growth patterns that they are unlikely to cause significant health problems. In these cases, MSKCC doctors will implement a program of regular monitoring to detect any signs of change in the tumor’s behavior.
Surgery is another primary treatment avenue for prostate cancer, and MSKCC surgeons are recognized globally for their expertise in prostatectomies. They are committed to continuous advancements in surgical techniques to enhance both safety and efficacy. Radical prostatectomy, the surgical removal of the prostate gland, is performed at MSKCC using various approaches, including robotic, laparoscopic, and open surgery. MSKCC surgeons are also highly skilled in salvage radical prostatectomy, a procedure considered when prostate cancer recurs after radiation therapy.
Radiation therapy is a vital treatment modality that utilizes high-energy beams to target and destroy cancer cells. By damaging the cells, radiation therapy inhibits their ability to reproduce and spread. MSKCC’s radiation oncology team is a world leader in prostate cancer radiotherapy, offering a wide range of advanced techniques. Their oncologists have extensive experience in:
- Brachytherapy (seed implants)
- External beam radiation therapy
- Intensity-modulated radiation therapy (IMRT)
- Image-guided radiation therapy (IGRT)
- Proton therapy
MSKCC physicians have pioneered and continue to refine these therapies, ensuring patients receive the most appropriate and effective radiation treatment. They leverage sophisticated tools, including advanced linear accelerators, cutting-edge imaging, and rapid computer-based systems, to deliver precise and powerful radiation doses directly to the tumor.
For small, localized tumors confined to the prostate, treatment options include focal therapy or partial gland ablation. Focal therapy encompasses non-invasive treatments that utilize freezing, heat, or electricity. Another targeted approach involves seed implants that selectively destroy only the cancerous portion of the prostate. This is particularly beneficial for patients who have experienced cancer recurrence within the prostate after prior radiation therapy. MSKCC’s brachytherapy specialists possess exceptional expertise in these intricate procedures.
In cases of aggressive cancers that carry a higher risk of spreading beyond the prostate, combination therapies are employed. These may involve hormone therapy, brachytherapy, and external beam radiation therapy. MSKCC’s approach prioritizes minimizing radiation exposure to healthy tissue while effectively targeting at-risk areas. This strategy allows for the delivery of high radiation doses to the prostate while reducing the long-term side effects of treatment and maximizing the chances of a cure.
Prostate cancer clinical trials at MSKCC provide patients with access to cutting-edge research studies evaluating innovative prostate cancer treatments. These clinical trials may offer access to therapies years before they become widely available.
For patients experiencing a rising prostate-specific antigen (PSA) level after radical prostatectomy, external beam radiation therapy, with or without hormone therapy, can be an effective treatment option. Hormone therapy can slow tumor growth and shrink prostate tumors, even in cases of cancer spread. During external beam radiation, radiation beams are precisely directed at the tumor using advanced techniques like IG-IMRT, minimizing long-term side effects for patients.
Prostate cancer that has spread outside the prostate is addressed with various systemic therapies, including:
- Hormonal therapies
- Chemotherapy
- Genomic-based treatments
- Immunotherapy
- Radiotherapeutics
- Biologics
- Clinical trials
MSKCC’s medical oncology experts collaborate to determine the optimal treatment plan based on the specific characteristics of each patient’s prostate cancer.
For advanced prostate cancer, MSKCC offers clinical trials focused on targeted therapies and novel treatment approaches. MSKCC’s research has significantly shaped the treatment landscape for advanced prostate cancer, pioneering the use of drugs like abiraterone acetate, enzalutamide, and rucaparib. MSKCC is at the forefront of developing advanced diagnostic imaging and genetic studies to personalize cancer treatment. Furthermore, MSKCC serves as the coordinating center for the Prostate Cancer Clinical Trials Consortium, a collaborative network of leading cancer centers dedicated to advancing early drug development and clinical trial design.
Oligometastatic prostate cancer, where cancer has spread to a limited number of sites, can be treated at MSKCC with stereotactic radiosurgery to target both the prostate and metastatic sites. This may be combined with surgery or systemic therapy to improve patient outcomes.
Comprehensive Follow-Up Care
MSKCC recognizes that prostate cancer treatment can sometimes lead to side effects. Their dedicated follow-up care programs are designed to help patients manage and overcome these challenges, with the goal of maintaining a high quality of life. The Male Sexual and Reproductive Medicine Program at MSKCC specifically addresses sexual and reproductive health changes experienced by men after cancer treatment. Additionally, the comprehensive Adult Survivorship Program provides support to help patients adjust during and after their cancer journey. Watch a video to learn more about MSKCC’s Adult Survivorship Program.
