A prostate cancer surgeon shares the latest advancements in the field and stresses the importance of early detection in managing the disease.
The American Cancer Society projects that in 2024, the United States will see approximately 299,010 new cases of prostate cancer and about 35,250 fatalities from the disease. Given that prostate cancer ranks as the second leading cause of cancer-related deaths among American men, after lung cancer, there is an understandable focus on the availability of new treatment options and the potential for a complete cure with these methods.
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Vipul Patel, MD, FACS, a board-certified urologic surgeon and medical director of the Global Robotics Institute and urologic oncology at AdventHealth Cancer Institute offers a hopeful outlook: “Prostate cancer is often highly curable with early diagnosis and treatment. We know that early testing leads to early detection of prostate cancer.” For this reason, Dr. Patel, who is also known for performing more robotic surgeries than any other surgeon worldwide—including over 16,000 robotic prostatectomies—strongly encourages patients to discuss prostate cancer screening options with their healthcare provider, as early detection significantly improves treatment outcomes.
The American Urological Association (AUA) recommends a baseline prostate-specific antigen (PSA) test for those between 45 and 50 years old and suggests earlier screenings for individuals at increased risk, such as those with African American heritage or a strong family history of prostate cancer.
For patients with advanced or metastatic prostate cancer—where the disease has spread beyond the prostate—Dr. Patel notes, “Achieving a complete cure becomes more difficult.” Although emerging treatments like hormone therapy, chemotherapy, immunotherapy, and targeted therapy can help manage the disease, they may not eradicate all cancer cells. In such instances, the treatment strategy shifts toward managing the cancer as a chronic condition, aiming to extend and preserve quality of life. Lifestyle factors such as diet, exercise, and stress management can also play a role in optimizing treatment outcomes and improving overall health.
Ahead, new prostate cancer treatments you should know about and the latest research that is revolutionizing prostate cancer diagnosis of.
New prostate cancer treatment options
Over the past five years, advancements in prostate cancer treatment have been specifically aligned with the type of prostate cancer diagnosed in patients:
- Localized prostate cancer: This type is confined solely to the prostate.
- Advanced prostate cancer: In these cases, the cancer has spread beyond the prostate. According to Dr. Patel, the treatment focus here is to “help prolong survival and improve outcomes for patients.”
Continue reading to learn about specific treatments for both localized and advanced prostate cancer.
Localized prostate cancer
1. Robotic surgery
“Robotic surgery to remove the entire prostate has now become the gold standard for treating clinically significant localized prostate cancer,” states Dr. Patel. This technique is the most prevalent surgical method for prostate cancer in the US and offers several advantages over traditional open surgery, including:
- Reduced bleeding during the operation
- Shorter hospital stays
- Faster recovery times for patients
These advantages occur in large part because the surgeon is able to calibrate and customize the robot’s approach to the patient’s unique anatomy. Throughout the procedure, the surgeon is controlling the robot’s parts, which acts as the doctor’s “hands”—just tinier. This usually means minimal invasiveness, the smallest incisions possible, and direct, targeted precision.
2. Focal therapy techniques
In recent years, focal therapy methods like high-intensity focused ultrasound (HIFU) and cryotherapy have drawn increasing attention. These techniques specifically target cancerous sections of the prostate, preserving the rest of the gland.
Despite their growing popularity, the AUA cautions that the long-term effectiveness of these focal therapies has yet to be extensively studied, and consequently, there is a reluctance to widely recommend these treatments until more data is available.
Advanced prostate cancer
1. Targeted hormone therapies
Prostate cancer is driven by male sex hormones, primarily testosterone. Dr. Patel points out that newer targeted hormone therapies, such as enzalutamide (Xtandi) and abiraterone (Zytiga), have proven effective in treating advanced prostate cancer. These therapies work by “specifically targeting molecules involved in the cancer’s growth,” offering a more focused approach to slow the disease’s progression.
2. Precision medicine
Precision medicine is transforming the treatment of prostate cancer through advancements in genomic testing and molecular profiling. Genomic testing involves analyzing specific gene mutations in a patient’s prostate cancer, while molecular profiling examines the broader genetic characteristics of the tumor. These cutting-edge technologies allow for the creation of personalized treatment plans for each patient’s tumor.
3. Multidisciplinary approach
The management of advanced prostate cancer has evolved into a collaborative effort. “It is now common for a combination of treating doctors—including urologists, radiation oncologists, and medical oncologists—to be involved in their care,” explains Dr. Patel. This integrated approach ensures that each patient’s needs are met, aiming for the best possible outcomes.
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Exciting prostate cancer research
There is new research that promises to transform prostate cancer care. Dr. Patel shares a few developments:
- MRI-guided prostate biopsy: This technique uses MRI imaging to enhance the accuracy of prostate biopsies, reducing the risk of overlooking clinically significant tumors.
- Liquid biopsies: These non-invasive tests analyze blood or urine for circulating tumor cells or other biomarkers, offering insights into prostate cancer detection, disease progression, tumor genetics, and treatment response.
- Artificial intelligence (AI): Dr. Patel’s team utilizes AI to analyze surgical videos, predict post-surgery outcomes, and improve the interpretation of MRI images for better prostate cancer detection. AI proves essential in identifying subtle patterns in imaging that might be overlooked by the human eye and can lead to better treatment planning.
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