Prostate Cancer Treatment Options

Doylestown Health's Cancer Institute provides men in our community with the most advanced treatment options available for prostate cancer. Some men may require a combination of treatments, and we offer every option available.

Treatment strategies depend on each man's individual circumstances, such as age and life expectancy, if cancer has spread or if it is contained to the prostate. Side effects from treatment are also a major consideration when determining a plan of care for prostate cancer, both in its early stages or when cancer has spread.

Comprehensive Approaches to Treatment

Doylestown Health's Cancer Institute offers the full range of treatment options for prostate cancer including the latest, state-of-the-art techniques. Not all men diagnosed with prostate cancer need treatment. Active surveillance or watchful waiting may be an option for cancers that are lower grade and slower growing, particularly in older men. Treatment of prostate cancer may include infusion therapy, radiation therapy, surgical methods, watchful waiting or a combination of different strategies.

Infusion Therapy

Doylestown Health's Cancer Institute's Outpatient Infusion Unit offers a spacious and comfortable environment for patients with prostate cancer to receive advanced infusion care such as:

• Hormone therapy: This therapy blocks the production of the male hormone testosterone which fuels the growth of cancer cells in the prostate. When testosterone levels are greatly decreased, the prostate cancer cells go into remission. Hormone therapy in early-stage cancer can shrink large tumors so surgery or radiation can remove or destroy the cancer more easily. In advanced prostate cancer, hormone treatment may be effective in shrinking and slowing the tumor's growth. Sometimes cancer cells start to grow again without testosterone and this therapy becomes less effective. If treatment becomes "hormone-resistant," then other options, such as chemotherapy, are prescribed.
• Chemotherapy: This treatment can effectively treat prostate cancer by killing the cancer cells, but cannot cure the cancer. Because chemotherapy has more side effects than hormone therapy, it is generally prescribed for men who have hormone-resistant prostate cancer that has spread beyond the prostate to other parts of the body.

Radiation Therapy

Penn Radiation Oncology Doylestown is an outpatient radiation treatment program located in The Pavilion on Doylestown Hospital's main campus. As a Penn Medicine satellite location, Doylestown Hospital is equipped with the most advanced technology including a state-of-the-art linear accelerator, which is a computer-controlled device that delivers radiation therapies or radiotherapies.

Doylestown Health urologists work closely with board-certified Penn radiation oncologists to treat patients with prostate cancer using advanced, precisely focused, high-energy rays, similar to X-rays, to target cancer in the prostate. Targeted radiation therapies limit radiation exposure to surrounding healthy tissue in the rectum and bladder to minimize side effects such as urinary incontinence, bowel problems or sexual dysfunction. We work as a team to offer our patients therapies such as:

• External beam radiation therapy (EBRT): This treatment comes from a machine that aims radiation at your cancer and rotates around you in many directions. The radiation is aimed specifically at the affected area, not the rest of your body.
• Intensity-modulated radiation therapy (IMRT): This treatment uses a 3-dimensional radiation therapy and computer-generated images to show the size and shape of the tumor. Thin beams of radiation at varying intensities target the tumor from many angles and to reduce the damage to healthy tissue near the tumor.
• Proton therapy: Patients who qualify may be evaluated and referred to Penn Medicine’s Roberts Proton Therapy Center. Proton therapy is a non-invasive, highly precise cancer treatment that uses protons at high speeds to destroy the DNA of cancer cells which kills them and prevents them from multiplying. The Proton Therapy Center is the largest and most advanced facility of its kind in the world and the only proton therapy center that is fully integrated with a National Cancer Institute (NCI) designated comprehensive cancer center.

Surgical Treatment

Radical prostatectomy is the surgical removal of the prostate, a treatment approach used primarily for prostate cancer that is confined to the prostate gland. At Doylestown Health, our surgeons have extensive experience in the three major types of radical prostatectomy including: perineal surgery, retropubic surgery and robotic-assisted laparoscopic surgery using the da Vinci® Surgical System.

• Perineal surgery: Surgeons at Doylestown Hospital and hospitals nationwide have performed perineal surgery on patients for decades. This traditional surgical approach provides the most direct access to the prostate gland and includes methods for nerve-sparing. The perineal approach is less disruptive to the urethra and bladder and best for avoiding urinary problems. Lymph nodes cannot be removed during this surgery.
• Retropubic surgery: This approach removes the prostate gland through an incision in the lower abdomen that runs from the navel to the pubic bone. Robotic-assisted laparoscopic prostatectomy surgery is replacing this approach in many instances.
• Robotic-assisted laparoscopic surgery: Since 2008, surgeons at Doylestown Hospital have operated on patients using the da Vinci® Surgical System. Our surgeons are highly trained and experienced with this system, which removes the entire prostate. During the procedure, our surgeons have advanced abilities for visualization with a computer and more flexibility as they control a robot to make smaller incisions in the abdominal area to remove the prostate. Patients benefit from decreased blood loss, shorter hospital stays and quicker recovery periods.

Watchful Waiting or Active Surveillance

Prostate cancer is often diagnosed early. Men over age 70 often choose a treatment option called watchful waiting or active surveillance. This approach repeats prostate-specific antigen (PSA) blood tests, rectal exams and periodic biopsies to monitor progression of the cancer. Men may choose this option if they are not experiencing symptoms, and if the cancer is small, confined and expected to grow slowly. Many men live normal lives without treatment. Often, prostate cancer does not spread or cause problems.