Prostate cancer is one of the most frequently diagnosed cancers in men. It occurs when abnormal cells grow uncontrollably in the prostate, a small reproductive gland that produces seminal fluid. Often, the cause is unknown.

Most prostate tumors develop slowly and do not cause noticeable symptoms until the cancer progresses. At that point, the patient may experience difficulty urinating, bloody urine or semen, erectile dysfunction, pelvic discomfort or other concerning warning signs. Because early-stage prostate tumors are often asymptomatic, routine screenings—such as a digital rectal exam (DREs) combined with a prostate-specific antigen (PSA) test—are essential to ensure early detection.

Prostate cancer primarily affects older men, with most cases diagnosed after age 50. While some types remain confined to the prostate and may not require immediate treatment, others can be aggressive and spread throughout the body. The optimal treatment approach can vary depending on several factors, including the stage and aggressiveness of the tumor and the overall health and preferences of the patient.

Treatment for early-stage prostate cancer

In many cases, active surveillance is an option for early-stage prostate cancer, particularly if the tumor is slow-growing and asymptomatic. This wait-and-watch approach generally involves regular DREs and PSA tests and occasional biopsies to monitor for changes in the cancer. Formal treatment will be delayed until the tumor causes symptoms or shows signs of spread, which can take several years. This way, the patient can avoid unnecessary treatment and the associated side effects. If the patient prefers a more proactive strategy, radiation therapy or surgery may be considered.

Dr. Wade Sexton, prostate cancer surgeon

Rated High Performing in Prostate Cancer Surgery

Recognized in U.S. News & World Report's Best Hospitals for significantly better performance in prostate cancer surgery than the national average.

Schedule an Appointment

Surgery for prostate cancer

Surgery is a common treatment for prostate cancer, particularly to address a tumor that has not spread beyond the prostate gland. The goal of surgical treatment is to remove the cancerous tissues while preserving as much normal function as possible.

The most common type of surgery for prostate cancer is radical prostatectomy, which involves the complete removal of the prostate gland, often including some nearby tissues such as the seminal vesicles and lymph nodes. This procedure is generally recommended for men with localized prostate cancer and a life expectancy of at least 10 years. Surgical techniques include:

Open radical prostatectomy for prostate cancer

During an open radical prostatectomy, the surgeon will make an incision in the lower abdomen (retropubic approach) or between the anus and scrotum (perineal approach) to access and remove the prostate gland. The retropubic approach allows for easy removal of nearby lymph nodes if needed, while the perineal approach can minimize blood loss. Both traditional open surgical techniques can be effective for treating prostate cancer; however, they typically involve a longer recovery and a greater risk of complications compared to minimally invasive surgery.

Laparoscopic radical prostatectomy for prostate cancer

Laparoscopic radical prostatectomy is a minimally invasive technique that involves the use of small incisions and specialized surgical instruments to remove the prostate gland. A miniature camera provides a magnified view of the surgical site throughout the procedure, allowing the surgeon to precisely remove the prostate while minimizing any damage to the surrounding structures. Compared to open surgery, this approach generally results in less blood loss and postoperative pain, as well as a quicker recovery, but it requires a high level of surgical expertise.

Robotic-assisted radical prostatectomy for prostate cancer

A refined version of laparoscopic radical prostatectomy, robotic-assisted radical prostatectomy involves the use of an advanced robotic surgical system for enhanced precision and control. The surgeon operates with robotic arms equipped with specialized surgical instruments, allowing for greater dexterity and a three-dimensional, high-definition view of the prostate. Compared to traditional surgery, this technique offers several potential benefits, including reduced blood loss, a shorter hospital stay and a lower risk of complications, such as incontinence and erectile dysfunction. As with any specialized surgery, the success of the procedure depends on the skill of the surgeon.

Nerve-sparing radical prostatectomy for prostate cancer

Nerve-sparing prostatectomy is a surgical technique used during radical prostatectomy to preserve the nerves responsible for erectile function. When possible, the surgeon will carefully avoid cutting or damaging the nerve bundles that run alongside the prostate. This approach is most effective when the tumor is confined to the prostate and does not involve the surrounding nerves. While nerve-sparing surgery can improve the chance of maintaining erectile function, the outcome can vary based on the extent of the cancer and the patient’s age and pre-existing sexual health.

The emotional toll of prostate cancer is often difficult for many men, and Robert was no exception.

Read Robert's Story

Request an Appointment

Irreversible electroporation ablation for prostate cancer

Irreversible electroporation (IRE) ablation is an advanced form of focal therapy designed to treat localized prostate cancer while preserving the surrounding healthy tissues. This innovative, image-guided technique aims to control the cancer while minimizing the side effects typically associated with more aggressive treatments.

As a minimally invasive outpatient procedure, irreversible electroporation ablation uses brief, high-voltage electrical pulses delivered through thin, needle-like electrodes to destroy cancerous cells. The pulses create tiny openings (nanopores) in the cell membranes, leading to irreversible cell damage and death without relying on radiation or heat.

IRE ablation can be particularly effective for precisely targeting and eliminating small prostate tumors that are visible with real-time magnetic resonance imaging (MRI). Because the procedure treats only the affected area of the prostate rather than the entire gland, it significantly lowers the risk of side effects, helping to preserve normal urinary and sexual function.

Radiofrequency ablation for prostate cancer

Radiofrequency ablation (RFA) is a minimally invasive treatment for prostate cancer that uses heat to destroy cancerous tissues. Guided by real-time imaging, such as MRI or ultrasound, the physician will insert a thin, needle-like probe directly into the prostate tumor. Using the probe, the surgeon will deliver high-frequency electrical currents, effectively targeting and destroying cancer cells while preserving the surrounding healthy tissues.

Typically performed on an outpatient basis, RFA potentially offers a shorter recovery time and involves less risk than more invasive treatments. It may be an option for a patient who has a localized or recurrent prostate tumor and is not a candidate for surgery or radiation therapy.

Cryoablation for prostate cancer

Cryoablation is a minimally invasive treatment that involves the use of extreme cold to destroy cancerous tissues. Guided by real-time imaging, the physician will insert a thin probe into the prostate and deliver a freezing gas, which will form ice crystals to eliminate the cancer cells. The physician will carefully control the process to precisely target the tumor while preserving the surrounding healthy tissues.

Often performed as an outpatient procedure, cryoablation can be an effective option for treating localized or recurrent prostate cancer. It may also be a suitable alternative for a patient who is not a candidate for surgery or radiation therapy.

Radiation therapy for prostate cancer

Radiation therapy involves the use of high-energy X-rays or other radioactive beams to destroy cancerous cells in a specific area of the body. When used to address prostate cancer, it can be delivered externally or internally.

External beam radiation therapy (EBRT) is delivered via a machine (linear accelerator), which is positioned outside the patient’s body. The linear accelerator generates high-energy beams directed at the tumor site. This non-invasive treatment can target cancer cells while minimizing exposure to the surrounding healthy tissues.

Internal radiation therapy (brachytherapy) is delivered via tiny radioactive implants—such as seeds, pellets or wires—which are surgically placed inside or near the tumor. The implants will steadily deliver a concentrated dose of radiation directly to the cancer cells while sparing nearby healthy tissues. Over approximately one year, the radiation will gradually diminish, and the inactive implant can safely remain in place for the rest of the patient’s life.

Radiation therapy for prostate cancer carries a risk of radiation burn (radiation proctitis) to the lower section of the large intestine, which is separated from the prostate by only a thin layer of tissue. This can make it challenging for the radiation oncologist to bombard the cancerous prostate cells with radiation without also grazing the nearby rectum. Symptoms of radiation proctitis include stomach cramping, painful bowel movements and rectal bleeding.

The risk of radiation proctitis during radiation therapy for prostate cancer can be greatly reduced through the use of hydrogel spacers. By injecting a specialized hydrogel that expands inside the body and creates about a half-inch buffer between the prostate and rectum, the physician can protect the rectum from the effects of the radiation. SpaceOAR hydrogel, a gel-like synthetic material made of water and polyethylene glycol (PEG), is approved by the U.S. Food and Drug Administration for this purpose.

Hormone therapy for prostate cancer

Normal prostate function requires certain hormones, which are naturally produced by the body. Known as androgens, these chemical messengers promote the growth of both normal and cancerous prostate cells by binding to and activating a certain protein (androgen receptor) found on the surface of the cells. The primary androgen is testosterone.

Most early-stage prostate tumors need a steady supply of androgens to grow. Androgen deprivation therapy (ADT) is a form of hormone therapy that can reduce the level of androgens in the bloodstream or block their activity, thereby inhibiting tumor growth.

The types of ADT include:

Surgical removal of one or both testicles – Known as orchiectomy, this permanent and irreversible procedure can reduce the level of testosterone in the blood by up to 95%.
Luteinizing hormone-releasing hormone (LHRH) agonists or LHRH antagonists – These injectable medications can stop the pituitary gland from producing luteinizing hormone, which in turn can stop the testicles from producing androgens. The effect is reversed once the treatment ends.
Androgen synthesis inhibitors – These medications, which are administered in pill form, can inhibit an enzyme (CYP17) needed for the production of androgens by the adrenal glands, testicles and prostate cells.

Chemotherapy for prostate cancer

Chemotherapy is a systemic treatment that involves the use of powerful cancer-fighting medications, which can be administered orally or intravenously. After entering the bloodstream, the drugs circulate throughout the body to target and destroy rapidly dividing cells, including cancer cells.

Because systemic treatment is not needed for a tumor confined to the prostate gland, chemotherapy is generally reserved for advanced-stage prostate cancer that has metastasized to distant tissues and organs. Even then, hormone therapy is usually the preferred treatment approach, although chemo may be considered to address a tumor that is resistant to ADT.

Immunotherapy for prostate cancer

Immunotherapy works by boosting the natural ability of the body’s immune system to fight cancer. Some immunotherapies strengthen the immune system in a general way, while others train the immune system to target and destroy specific cells or proteins. One type of immunotherapy for prostate cancer is administered in the form of a vaccination. Unlike a prophylactic immunization designed to prevent a virus, such as a flu shot, a cancer vaccine is designed to help the immune system identify and attack cancer cells already present in the body.

Currently, prostate cancer is the only type of cancer that can be treated with a vaccine. Known as Provenge®, this novel treatment is approved by the U.S. Food and Drug Administration (FDA) for addressing advanced prostate cancer, including metastatic tumors that do not respond to other therapies. Precisely tailored for each case, Provenge® uses the patient’s own immune cells, which are altered in a lab to target the PAP protein found on the surface of prostate cancer cells.

Although Provenge® is not a curative treatment, it can slow the progression of prostate cancer and potentially improve the patient’s outcome and quality of life. Other prostate cancer vaccines are currently under study in clinical trials.

Pluvicto treatment for prostate cancer

Pluvicto is a targeted radioligand therapy that binds to prostate cancer cells, delivering radiation to tumors while preventing harm to healthy tissues. This groundbreaking radioactive medication is approved by the U.S. Food and Drug Administration (FDA) for patients who have prostate-specific membrane antigen (PSMA)-positive prostate cancer. Pluvicto may be a particularly good option for a patient whose cancer has spread beyond the prostate to other areas of the body despite other treatments.

Frequently asked questions (FAQs) about prostate cancer treatment

The following FAQs-related articles provide additional information about prostate cancer treatment:

Benefit from world-class care at Moffitt Cancer Center

Moffitt is firmly positioned at the forefront of prostate cancer treatment. In addition to an extensive range of innovative therapies, we have one of the most robust clinical trial programs in the nation. These carefully controlled studies allow our patients to be among the first to benefit from promising new therapies before those options are made available in other settings.

If you would like to learn more about prostate cancer treatment, you can request an appointment with a specialist in Moffitt’s Urologic Oncology Program by calling 1-888-663-3488 or submitting a new patient registration form online. We do not require referrals.

Helpful Links:

Lloyd, Prostate Cancer Survivor and Moffitt volunteer

Meet Lloyd

Inspired by the support he received as a patient, Lloyd wanted to give back as a volunteer.

Treatment

Prostate Cancer Treatment