Prostate cancer treatment: what you need to know


When it comes to prostate cancer treatment, there’s bad news and there’s good news.

The bad news: Prostate cancer ranks the third most common cancer in the U.S. Healthcare providers diagnose more than 200,000 new cases each year. Approximately 14 percent of men will succumb to prostate cancer in their lifetimes. The good news: Most diagnosed with prostate cancer survive. The disease represents 13.3 percent of all new cancer cases. But only 4.7 percent of those diagnosed will die of the disease. Research shows five-year relative survival rates for prostate cancer at 99.7 percent. (National Cancer Institute)

And, proton therapy offers a treatment option for prostate cancer with many fewer short-term and long-term side effects.

The basics

Prostate cancer typically spreads slowly and in many cases does not cause health problems. However, those at higher risk for the disease should consult with their healthcare provider about being screened for prostate cancer. Early detection vastly improves long-term outcomes. Those at higher risk include:

  • Men 50-years-old or more
  • African American men
  • Men 45-years-old or older with a first-degree relative (father, brother or son) diagnosed with prostate cancer before age 65
  • Men 40-years-old or older with more than one first-degree relative who had prostate cancer before age 65

Screening options include:

  • A digital rectal exam, conducted by the physician to determine the size of the prostate and feel for tumors
  • A test measuring levels of prostate specific antigen, or PSA, in the blood. And elevated PSA test can indicate the presence of cancer but also noncancerous conditions such as prostatitis.
  • A biopsy may be recommended, if PSA levels are high or have risen over time, to look for tumors in the prostate

Those with PSA levels of less than 2.5 ng/mL should be re-tested every two years. Those above 2.5 ng/mL should be tested every year.

Proton therapy and prostate cancer

For men diagnosed with prostate cancer, the cure can be worse than the disease.

Traditional treatments such as surgery, conventional radiation therapy and brachytherapy come with a number of undesirable side effects. These include incontinence and impotence due to damage of healthy surrounding tissues and organs that enable these important functions.

Proton therapy represents an advanced form of radiation therapy that uses a beam of high-energy protons to treat various forms of cancer. Unlike conventional radiation therapy, in which x-ray beams deposit most of their energy into the healthy tissue prior to entry and upon exit of the tumor site, the protons can be better controlled, allowing most of the energy to be deposited directly into the tumor. This reduces damage to nearby healthy tissue.

Prostate patients who chose proton therapy saw a 5 percent recurrence rate. That compares to a 20 percent recurrence rate for conventional radiation therapy. And proton therapy patients experienced a 12 percent chance of complications and acute side effects. This compares to a 60 percent chance of complications and acute side effects for those treated with photons.

Men treated with proton therapy have a very low risk of long-term side effects. These can include incontinence and bowel damage.

Additional protection

Provision has taken further steps to reduce side effects and enhance patient comfort. It was the first proton therapy center in the nation to adopt use of SpaceOAR hydrogel, an injectable spacer that protects the rectum during radiation therapy for prostate cancer.

Placed through a small needle, the hydrogel is administered as a liquid that quickly solidifies into a soft gel. The gel expands the space between the prostate and rectum. This temporarily positions the anterior rectal wall away from the prostate during treatment. The hydrogel spacer maintains this space until proton therapy is complete. The spacer then liquefies and is absorbed and cleared from the body in the patient’s urine.

“By its nature, proton therapy’s targeted radiation dosage protects surrounding tissues from damage,” says Ben Wilkinson. Wilkinson serves as radiation oncologist and medical director for Provision Center for Proton Therapy. “The SpaceOAR product provides us with even more ability to keep our patients comfortable and further prevent long-term side effects as a result of their treatment.”

Don’t take our word for it

In a recent national survey men reported the dramatic difference between proton therapy and other cancer treatments. Those who received proton therapy said they experienced significantly better quality of life during and after treatment than those treated with surgery or traditional x-ray therapy. The survey carried out by Bryant Research profiled 755 men, ages 50-75. They were surveyed at least 12 months after treatment.

Patients who received proton therapy reported less interference with sexual function.They also described feeling better during treatment. And they experienced fewer problems with urinary function, bowel function, digestive function and the ability to stay active.

Other notable results included:

  • The proportion of proton therapy patients reporting that their treatment had no impact on their sexual function was almost double that of the next best scoring treatment in this survey.
  • Ninety-seven (97%) percent of proton therapy patients said they would recommend their treatment to other men with prostate cancer, significantly higher than the other treatment options.
  • Ninety-seven (97%) percent of proton therapy patients said they would select this same treatment option should they have to make the decision today compared to brachytherapy (68%), conventional radiation therapy (66%), and surgery (58%) patients.