Treatments and Therapies for Prostate Cancer

Page Contents

Fred Hutch Cancer Center provides comprehensive care for men with all stages and grades of prostate cancer. We offer advanced therapies and new options available only through clinical studies.

The most common treatments for prostate cancer are active surveillance, watchful waiting, surgery and radiation therapy. Men with high-risk or advanced disease might have hormone therapy, chemotherapy, immunotherapy or targeted therapy as well. We’ll tailor your treatment to you.

Prostate Cancer Care Tailored to You

You and your family are our top priority. At Fred Hutch Cancer Center, we offer comprehensive and compassionate care — personalized to you. You'll have access to the latest treatment options, clinical trials and supportive care services. 

Request an Appointment

Prostate Cancer Multispecialty Clinic

At Fred Hutch, many men see the team at our Prostate Cancer Multispecialty Clinic (PCMC). At this clinic, a urologic oncologist, medical oncologist and radiation oncologist come together to see you on the same day. Along with a radiologist and pathologist, they plan treatment to meet your needs. If you have high-risk, localized prostate cancer, this clinic is designed for you.

How We Treat Prostate Cancer at Fred Hutch 

Active Surveillance and Watchful Waiting for Prostate Cancer

Prostate cancer doesn’t always need to be treated right away. In fact, some men don’t need treatment for many years. It depends on the features of your disease. Instead of treatment, your physician may suggest checking your condition on a regular schedule to see if anything is changing. Fred Hutch prostate cancer experts have the knowledge to help you decide if this approach is right for you.

Learn About Active Surveillance and Watchful Waiting for Prostate Cancer

Prostate Cancer Surgery

If you need surgery for prostate cancer, this often means taking out the entire prostate and some nearby tissue. At Fred Hutch, our skilled surgeons from UW Medicine do everything they can to save the nerves that control your ability to have an erection. In certain cases, your surgeon may be able to destroy the cancer cells in your prostate without taking out the gland itself — using cold (cryosurgery), electrical current (irreversible electroporation) or sound energy (high-intensity focal ultrasound).

Learn About Prostate Cancer Surgery

High Intensity Focal Ultrasound for Prostate Cancer

High-intensity focal ultrasound (HIFU) uses strong, highly focused sound energy. It heats a small target area, about the size of a grain of rice, destroying the cells in that spot. It’s noninvasive — there’s no incision. Fred Hutch was the first cancer center in the Puget Sound region to offer HIFU. Your Fred Hutch care team may suggest HIFU if you have cancer in only a small part of your prostate.

Learn About HIFU for Prostate Cancer

Radiation Therapy for Prostate Cancer

There are several types of radiation therapy that may be useful to treat prostate cancer, including:

  • Putting radioactive “seeds,” or pellets, in the prostate (brachytherapy)
  • Giving you a drug that delivers small “packages” of radiation to cancer cells (molecular therapy)
  • Aiming a high-energy beam at your prostate from a machine outside your body (external-beam radiation therapy, EBRT)
Learn About Radiation Therapy for Prostate Cancer

Proton Therapy for Prostate Cancer

Proton therapy is a highly precise type of radiation therapy. It allows your radiation oncologist to pinpoint the peak dose of radiation within your prostate. This level of precision can help protect nearby healthy tissue, leading to fewer side effects. Fred Hutch Cancer Center – Proton Therapy, led by world-class experts, is the only proton therapy center in the Pacific Northwest.

Learn About Proton Therapy for Prostate Cancer

Hormone Therapy for Prostate Cancer

Testosterone, the main male hormone, may cause prostate cancers to grow. So, to treat prostate cancer, your care team may recommend ways to:

  • Reduce your testosterone level
  • Keep testosterone from reaching your cancer cells

Usually, this means taking medicine. Hormone therapy for prostate cancer is also called androgen-deprivation therapy or androgen-suppression therapy.

Learn About Hormone Therapy for Prostate Cancer

Chemotherapy for Prostate Cancer

Chemotherapy helps to destroy cancer cells wherever they may be in your body. Usually, it means you get anti-cancer medicine through an intravenous (IV) line. Then the medicine travels throughout your body through your bloodstream. Chemotherapy does not typically cure prostate cancer, but it may help extend your life or improve your quality of life if your cancer is advanced or it comes back after treatment.

Learn About Chemotherapy for Prostate Cancer

Immunotherapy for Prostate Cancer

Fred Hutch is a leader in developing immunotherapies and giving patients early access through clinical trials. Our center was the site for several of the studies that led to approval of a prostate cancer vaccine, sipuleucel-T, by the U.S. Food and Drug Administration. This vaccine may help prolong your life if you have advanced, metastatic prostate cancer. Medicines called immune checkpoint inhibitors are another option for some people, and cellular immunotherapy is in clinical trials.

Learn About Immunotherapy for Prostate Cancer

Targeted Therapy for Prostate Cancer

Targeted therapies are newer cancer treatments that work more selectively than standard chemotherapy. Targeted therapies work in one of three ways:

  • They target a gene or protein that causes cancer growth
  • They damage cancer cells directly
  • They tell your immune system to attack certain cells

Targeted therapies may be helpful if your cancer has spread or come back after treatment and your cancer cells have certain genetic changes. The Fred Hutch Prostate Cancer Genetics Clinic can test your cancer cells to see if they might respond to targeted therapies.

Learn About Targeted Therapy for Prostate Cancer

Diet and Exercise for Prostate Cancer 

There are many ways you can positively influence your health if you have prostate cancer. Every day, the foods you choose to eat and the exercise you get can affect your overall health. They can also affect your prostate cancer recovery and survival. Your Fred Hutch care team will support you in making healthy choices that work for you and your family. We also offer resources and guidance on how to get started in making changes after a cancer diagnosis.

Learn About Diet and Exercise for Prostate Cancer

Our Prostate Cancer Care Team

At Fred Hutch, we surround you with prostate cancer experts who design a treatment plan custom-made for you. You may choose to visit one of our prostate specialists for a specific type of treatment. Or you may choose a team approach, where our specialists collaborate, discuss all your options and then recommend a plan.

Learn About Our Prostate Cancer Specialists

Why Choose Fred Hutch for Prostate Cancer Treatment

The choices you make for your prostate cancer treatment are personal. A key to making good decisions is getting input from experienced prostate cancer specialists, like our team at Fred Hutch. Our experts know the outcomes and quality-of-life issues for each treatment method. 

Team-Based Care from Specialists

Fred Hutch has urologic oncologists, medical oncologists, radiation oncologists, molecular therapy specialists and pathologists who specialize in prostate cancer. We offer the most advanced diagnostic, treatment and recovery programs. Along with treating your cancer, we also offer a range of services to support you and your caregiver. This is part of how we take care of you — not just your disease. From registered dietitians to Spiritual Health clinicians to social workers, our experts know how to care for people with prostate cancer.

Treatment Tailored to You

We view treatment as a collaborative effort. Your Fred Hutch physicians will explain all your options. We’ll recommend a treatment plan to get you the best results based on the grade and stage of your cancer, the potential side effects and your age and overall health. Data from cancer centers across the country show that men who start prostate cancer treatment at Fred Hutch have higher survival rates on average than those who started at other centers.

Clinical Trials to Improve Outcomes

Many of our patients receive promising therapies by taking part in prostate cancer clinical trials. These research studies are done by physician-scientists from Fred Hutch and UW Medicine, including through the Institute for Prostate Cancer Research. They test new treatments or new ways to use current treatments. Every advance in cancer treatment in recent years has come out of clinical trials. By doing trials, we can offer more treatment options for people like you.

Prostate Cancer Treatment FAQ

The most effective treatment for you will depend on the features of your cancer. Your Fred Hutch care team will consider many factors, including:

  • If cancer is only in your prostate (localized)
  • If your cancer has a tendency to spread (high risk) or it has come back after treatment (recurrent)
  • If your cancer has already spread when you are diagnosed (advanced or metastatic)

For nearly eight in 10 men with prostate cancer, the disease is diagnosed early, in the local or regional stages. Most will be cured. The most common treatments for this group are active surveillance, watchful waiting, surgery and radiation therapy.

One in five men with prostate cancer are diagnosed with high-risk disease — localized prostate cancer that is likely to spread. Among these men, about one-third will have cancer that comes back after treatment. Physicians use hormone therapy, along with surgery and radiation therapy, to treat prostate cancers that might have spread.

If prostate cancer has already spread when you are diagnosed, new treatments may put it in remission and give you a good quality of life for years. The cancer can’t be cured. But you could get good results from immunotherapy, hormone therapy, chemotherapy, radiation therapy (including molecular therapy), targeted therapy or promising therapies in clinical trials.

There are tools to help patients and physicians decide on treatment for prostate cancer. They predict how well surgery or radiation is likely to work and how likely these treatments are to cure the disease. Talk with your Fred Hutch care team to find out what these tools say about the best treatments for you.

In general, people who have the same stage of prostate cancer often have the same or similar treatments. But the stage of the disease is not the only important factor. You care team will take other factors into account, too, like the risk that your cancer will spread.

Some patients have a combination of treatments. But not everyone needs all the treatments listed here. Common treatments by stage may include:

  • Stage I (1): Watchful waiting, active surveillance, surgery or radiation therapy (sometimes followed by hormone therapy).
  • Stage II (2): Watchful waiting, active surveillance, surgery, radiation therapy or hormone therapy.
  • Stage III (3): Watchful waiting, active surveillance, surgery, radiation therapy or hormone therapy.
  • Stage IV (4): Watchful waiting, active surveillance, radiation therapy, hormone therapy, chemotherapy, bisphosphonates (medicines to lower the risk of bone fracture) or molecular therapy (a type of internal radiation therapy) for cancer that has spread to the bones.

You might have further options in certain situations, like if your cancer has certain genetic changes or if it has come back. Along with many of the options listed above, you might have immunotherapy with sipuleucel-T or an immune checkpoint inhibitor or get a targeted therapy called a PARP inhibitor.

Fred Hutch offers all standard treatment for prostate cancer. Our patients also have access to newer options or treatment combinations that you can only get through clinical trials.

Fred Hutch researchers are always looking for better ways to treat prostate cancer. We are doing clinical trials of new drugs and drug combinations to treat men in different situations. 

Learn about prostate cancer research.