Medical oncologists specializing in prostate and urologic cancers offer a full range of biologic targeted therapies and chemotherapy for all types and stages of cancer.
Physicians will determine if a person has low-, intermediate-, or high-risk prostate cancer by evaluating the size of the prostate, the PSA, and the results of the biopsy.
Low-Risk Prostate Cancer
People are diagnosed with low-risk prostate cancer if their tumor stage is T1 or if they have a Gleason score of 6 or less.
- Low-risk prostate cancer is not an immediate risk to a person's health or well-being, so these people will either undergo surgery or radiation or may be put on an "active surveillance" status.
- Typically, a patient with low-risk disease will be evaluated by all three specialties (urology, radiation oncology, and medical oncology) prior to making a treatment decision.
If active surveillance is chosen, patients must follow up with their urologist for regular checkups and tests that may include:
If tests show the cancer is growing or becoming more aggressive, physicians may recommend surgery, radiation therapy, or other treatments.
Intermediate-Risk Prostate Cancer
Patients with intermediate-risk prostate cancer may either undergo surgery or radiation.
If radiation is chosen, patients also will be treated with hormonal therapy for a limited amount of time, typically about six months.
High-Risk Prostate Cancer
High-risk cancers are those that cannot be cured with either surgery or radiation alone.
In a man who has high-risk disease at diagnosis (tumor stage T3, Gleason score of 8 or greater, or PSA of 20 or greater), the standard treatment is the combination of radiation and hormone therapy for a longer period of time, usually two years.
Advanced Prostate Cancer
Some prostate cancers recur and metastasize (spread to other parts of the body) and cannot be cured; but in many cases, even advanced prostate cancers can be successfully controlled for years.
Treatment of advanced prostate cancer employs a number of different systemic modalities — treatment that attacks the cancer at all sites.
The different systemic therapies include:
Hormone Therapy for Prostate Cancer
Hormone therapy is the mainstay of systemic treatment at several stages of prostate cancer.
- Hormones are chemical substances produced by glands in the body that enter the bloodstream and affect other tissues.
- Prostate cancer grows when exposed to the male hormone testosterone.
- Testosterone is produced by the testes, adrenal glands, and, in advanced stages of cancer, by the cancer itself.
- The object of hormonal therapy is to block the production of testosterone and/or block the action of testosterone on the cancer, thereby delaying the growth of cancer.
In addition to already well-established hormonal therapies, a number of new agents are currently under development to further improve hormonal treatment for prostate cancer.
Chemotherapy for Prostate Cancer
Depending on the type and stage of the cancer, chemotherapy may be:
- Taken by mouth
- Taken as an injection
- Placed directly into the tumor site
Prostate Cancer Investigational Therapy
People have access to the latest investigational therapies and clinical trials at UPMC Hillman Cancer Center, western Pennsylvania's only National Cancer Institute-designated Comprehensive Cancer Center.
When appropriate, people with prostate cancer are placed on a Clinical Pathways – a disease-specific treatment strategy developed by physicians – to ensure that all patients receive the same evidence-based care.
Each pathway combines innovative and promising clinical trial options with the best standard of care therapies. Ongoing review by the clinical team ensures that each pathway remains the best and most effective treatment option available.