Prostate Cancer Treatment

Surgery for Prostate Cancer

Surgery is a common choice to try and cure prostate cancer if it is not thought to have spread outside the gland.

The main type of surgery for prostate cancer is known as radical prostatectomy. In this operation, the surgeon removes the entire prostate gland plus some tissue around it, including the seminal vesicles. A radical prostatectomy can be done in different ways.

• Open approaches to radical prostatectomy: In the more traditional (open) approach to doing a prostatectomy, the surgeon operates through a single long incision in the abdomen to remove the prostate and nearby tissues. If there is a reasonable possibility the cancer has spread to the lymph nodes around the prostate, the lymph nodes may be removed as well and sent to the lab for testing.
• Laparoscopic approaches to radical prostatectomy: For a laparoscopic radical prostatectomy (LRP), the surgeon makes several small incisions in the abdomen through which special long instruments are inserted to remove the prostate. One of the instruments has a small video camera on the end, which lets the surgeon see inside the abdomen. Laparoscopic prostatectomy has some advantages over the usual open radical prostatectomy, including less blood loss and pain, shorter hospital stays (usually no more than a day), and faster recovery times (although the catheter will be needed for about the same amount of time).

• Robotic prostate surgery: Laparoscopy may be effective for many routine procedures, but it has its limits in prostate surgery due to the complexity of these procedures. For those who are candidates for robotic-assisted prostate surgery, the da Vinci® surgical system offers an alternative to traditional and laparoscopic surgeries. It allows surgeons to perform delicate and complex operations through a few tiny incisions with increased vision, precision, dexterity and control.  Robotic surgery benefits include less pain and blood loss, less scarring, shorter recovery time and hospital stay, lower rate of surgical complications and quicker return to daily activities.

Radiation Therapy for Prostate Cancer

Radiation therapy is administered at CentraState’s Karen Olbis Radiation Oncology Center by highly trained radiation oncologists plus a full staff of registered radiation therapists, registered nurses, radiation physicists and dosimetrists. Radiation therapeutic approaches for prostate cancer include:

• External beam radiotherapy (EBR): A special machine called a linear accelerator is used to deliver high doses of radiation to the cancer site while limiting exposure to healthy tissues and organs and minimizing side effects. EBR includes:
  • 3-D conformal radiotherapy
  • Intensity-modulated radiation therapy (IMRT)
  • Image-guided radiation therapy (IGRT)
• Internal Radiation Therapy (Brachytherapy for prostate cancer): During internal radiation therapy, also called brachytherapy, a radioactive implant is put inside the body in or near the tumor in a usually painless procedure. For prostate cancer, this includes radiation seed implantation (low dose rate brachytherapy) and high-dose rate (HDR) brachytherapy.

Proton Therapy for Prostate Cancer

Proton therapy is an effective treatment for many forms of cancer, including prostate cancer, because doctors can precisely target the tumor while minimizing damage to the surrounding healthy tissues. Protons can be conformed to release much of their energy at precise depths so they can target tumors inside the body.

Procure Treatment Centers in Somerset and Princeton Radiology, in collaboration with CentraState, brought the first proton therapy center to the New Jersey/New York region.

The radiation oncologists who work in our proton center are experts in this highly specialized field.

Chemotherapy for Prostate Cancer

Chemotherapy is sometimes used if prostate cancer has spread outside the prostate gland and hormone therapy isn’t working. Chemotherapy is provided at the Jean Mehr Infusion Therapy Center offered through CentraState Medical Center’s Pharmacy Department and administered by Magnet-designated nurses credentialed in chemotherapy and certified in cancer care.

Clinical Trials for Prostate Cancer

Some patients may be eligible to participate in clinical trials for prostate cancer in which they receive an emerging prostate cancer treatment before it becomes publicly available. Talk to your oncologist or surgeon to learn more. You may also want to speak with your cancer navigator.

Minimizing Side Effects with Spaceoar

At the Statesir Cancer Center at CentraState, our prostate cancer specialists were the only physicians in New Jersey chosen for a successful nationwide clinical trial of SpaceOAR—a hydrogel that creates a space between the prostate and organs at risk during radiation.

Placed between the prostate and rectum, SpaceOAR (“organ at risk”) hydrogel pushes the rectum out of the high-dose radiation region while treating the prostate. Like prostate cancer cells, cells in the rectum are also damaged by the high-dose radiation. That’s why the rectum is called the “organ at risk” during prostate radiation therapy.

The hydrogel spacer is injected between the rectum and prostate with a syringe to increase the distance between those organs. Once in place—patients typically can’t feel the spacer. It remains in place for approximately three months (long enough to complete the radiation treatments) and is then absorbed by the body and leaves the body via the patient’s urine.

SpaceOAR can significantly improve a patient’s daily quality of life — bowel function is much less likely to be affected by radiation side effects.

Other benefits include:

• Enhanced precision and safety
• Decreased radiation dose to healthy issue
• Decreased side effects and complications