Alternatives to Prostate Removal Surgery for Cancer Patients

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Alternatives to Prostate Removal Surgery for Cancer Patients

Prostate cancer is unlike other types of cancer because most men have time to consider their options before treatment needs to begin. Naturally, there are a lot of questions. Although your oncologist will ultimately help you determine the treatment plan that’s best, educating yourself on options can be useful in understanding the recommendations you receive.

Do All Men With Prostate Cancer Need Their Prostates Removed?

For many men, prostate removal surgery called a prostatectomy can be avoided. This is to help avoid significant side effects that many men experience, sometimes permanently, including urinary incontinence and erectile dysfunction. Because of this, it’s a good idea to consider other cancer treatments that keep the prostate intact when possible.

Determining the Prostate Cancer Treatment That’s Right For You

Once prostate cancer has been detected, graded, and given a Gleason score, your doctor will most likely refer you to a cancer specialist called an oncologist. The cancer care team will review the data and other factors like your age, the stage of the cancer, the presence of symptoms, and your overall general health before making the best recommendation.

You may be interested in reading our blog: How to Read a Prostate Cancer Pathology Report

The stage of cancer helps your oncologist determine how far cancer has spread throughout the body – if at all. 

  • Stage 1 prostate cancer exists in the prostate only.
  • Stage 2 prostate cancer has advanced more than stage 1 but hasn’t yet spread to any other body parts. 
  • Stage 3 prostate cancer may still only exist on the prostate but covers more prostate than stage 2 and is accompanied by an abnormal PSA level. Stage 3 prostate cancer has sometimes spread to some of the surrounding tissues. 
  • Stage 4 prostate cancer has spread to other parts of the body.

This is only a brief overview of the stages, as they can be further broken down for each patient’s unique situation. Learn more about the staging of prostate cancer.

If the cancer has moved outside of the prostate (Stage 4), you’re more likely to need treatment right away. But for those patients who have cancer that’s contained inside the prostate and is low grade, there are a few treatment options to consider starting with a watchful waiting approach.

Active Surveillance for Prostate Cancer

One common approach to treating prostate cancer is active surveillance. This treatment method is typically used when prostate cancer surgery or treatment could cause more harm than the cancer in its current state. Active surveillance, which is more hands-on compared to watchful waiting, requires more routine checkups and screenings to evaluate any changes in the cancer to determine if other intervention methods are worth pursuing. Additional treatment can be implemented if there is a marked change in lab values or other aspects of the patient’s overall condition. 

Related reading: Prostate Cancer: Watchful Waiting vs. Active Surveillance

Treatments for Prostate Cancer Other than Surgery

When the time is right for treatment to begin, there are several approaches that don’t include surgery. One or more of these prostate cancer treatments may be recommended, and for some men, surgery is never necessary.

Hormone Therapy

Hormone treatment is frequently used when prostate cancer has spread to other parts of the body. For some men, the cancer can be controlled for two or three years, but other individuals may have a much shorter response to hormone therapy. In time, most prostate cancer can grow with very little or no male hormones. At that time, hormone therapy alone is no longer helpful and another treatment may be needed. 

Radiation Therapy for Prostate Cancer

There are two types of radiation therapy used for prostate cancer. One or both can be used to treat prostate cancer.

External beam radiation therapy (EBRT) is the most commonly used radiation therapy. It is more precise today than ever, with minimal damage caused to other organs near the prostate. The radiation is used to kill the cancer cells in the prostate.

Internal radiation therapy, known as brachytherapy, allows radiation to be delivered from inside the body using seeds that are surgically placed inside the prostate. As the seeds break down, they release radiation that kills the cancer cells.

Compass Oncology radiation oncologists are located throughout Portland-Vancouver and provide cancer patients with the latest radiation therapies. 

Find a Radiation Oncologist

Targeted Therapy

Targeted therapy is designed to treat specific genetic mutations or proteins found in the cancer. There are some targeted therapies approved for advanced prostate cancer.


Chemotherapy is typically used when prostate cancer has advanced outside of the prostate and affected lymph nodes or other areas of the body. It may be combined with other treatments.

Clinical Trials for Treating Prostate Cancer

All of the treatments available today for prostate cancer are the result of prostate cancer clinical trials. More treatments are currently under study in the hopes of finding new and better treatment options. Being involved in a clinical trial not only can help you, but it can also help future patients. Several trials are underway for new prostate cancer treatments, including:

  • Cryotherapy may be recommended for prostate cancer in early or advanced stages and involves freezing the cancer cells.  
  • High-intensity-focused Ultrasound Therapy is typically used for stage 1 and stage 2 prostate cancer and involves using an endorectal probe to kill cancer cells using ultrasound waves.
  • Proton Beam Radiation Therapy is a radiation therapy that uses protons to destroy cancer cells. This treatment can be slightly less damaging to the surrounding tissues than typical radiation therapy. 
  • Photodynamic Therapy involves the patient taking a drug that is activated by light. The drug collects more in cancer cells than healthy cells and is activated by laser lights administered through a fiber-optic tube. 

Trials are also underway to test new combinations of existing treatments for better outcomes. 

Finding the Right Prostate Treatment Plan 

If you or a loved one has recently been diagnosed with prostate cancer, request a consultation with the specialists at Compass Oncology. You may not need treatment right away, but a plan can be put in place.  

If you’ve consulted with someone already about a prostate cancer treatment plan, our specialists are available for second opinions so that you can feel confident in the course of action that’s best for you. 

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