Parkland Medical Center - August 20, 2018

While prostate cancer is the second most common cancer in men in the United States, the incidence rate has been declining since the early 1990s.

Currently, there are seven types of treatment for prostate cancer that are considered standard, with more being studied in clinical trials.

Standard Treatments for Prostate Cancer

Watchful waiting

  • Generally used for older men with prostate cancer who have no symptoms
  • Treatment is withheld until symptoms appear.
  • Ongoing tests such as digital rectal exam, PSA test, transrectal ultrasound, and transrectal needle biopsy, monitor if the cancer is growing, at which point treatment is given to slow or cure the cancer.


  • For patients in good health whose tumor is localized in the prostate gland
  • Can include any of the following types of surgical procedures:
    • Radical prostatectomy : removes the prostate, surrounding tissue and seminal vesicles, either by a retropubic prostatectomy (incision through the abdominal wall) or perineal prostatectomy
    • Pelvic lymphadenectomy: removes the lymph nodes in the pelvis to examine them for cancer cells
    • Transurethral resection of the prostate (TURP): uses a resectoscope to remove tissue from the prostate, treat benign prostatic hypertrophy, relieve symptoms caused by the tumor or treat men who cannot have a radical prostatectomy
  • Depending on the size and location of the tumor, may include nerve-sparing surgery to save the nerves that control erection

Radiation therapy

  • The type of radiation therapy depends on the type and stage of the cancer being treated.
  • Can be external radiation therapy (sent from a machine into the body directly at the cancer), internal radiation therapy (placing a radioactive substance sealed in needles, seeds, wires or catheters directly into or near the cancer) or radiopharmaceutical therapy (using a radioactive substance to treat cancer).
  • Radiation therapy for prostate cancer can increase the risk for bladder and/or gastrointestinal cancer.

Hormone therapy

  • Reduces the amount of male hormones or blocks them from working, thereby preventing the prostate cancer cells from growing
  • Can include luteinizing hormone-releasing hormone agonists to stop the testicles from making testosterone; antiandrogens to block the actions of androgens; drugs that stop adrenal glands from making androgens; estrogens to prevent the testicles from making testosterone (rarely used because of risk of serious side effect) and orchiectomy (surgical removal of one or both testicles)


  • Stops the growth of cancer cells, either by killing the cells or by preventing them from growing
  • Can be oral or injected into a vein or muscle (systemic chemotherapy) or placed directly into the cerebrospinal fluid, an organ or a body cavity such as the abdomen (regional chemotherapy)

Biological therapy

  • Uses the patient's immune system to boost, direct or restore the body's natural defenses to fight cancer
  • Can include Sipuleucel-T Ñ technically a cancer vaccine that boosts the immune system to attack cancer cells
  • Most effective in cases of metastatic prostate cancer

Bisphosphonate therapy

  • Reduces bone disease when cancer has spread to the bone by preventing or slowing the growth of bone metastases
  • Currently being studied in clinical trials

Treatment Options for Prostate Cancer