Newest ways to treat, eliminate prostate cancer

There’s menacing data showing that one in eight men will receive a prostate cancer diagnosis over their lifetime. 

The American Cancer Society (ACS) says other than skin cancer, prostate cancer is the most common cancer in men in the United States.

The good news? Prostate cancer, when caught early, is also one of the easiest to treat.

Salman Syed, MD, a radiation oncologist with OSF HealthCare, describes today’s current treatment options as “exceptional,” noting that most men diagnosed with prostate cancer at an early stage are successfully treated and remain cancer-free after therapy.

The best way to detect prostate cancer early is through screening with a PSA (prostate-specific antigen) test, Dr. Syed explains.

PSA is a protein produced by the prostate that can be measured with a simple blood test. Higher PSA levels may indicate prostate cancer or other prostate conditions. "It correlates with the amount of prostate tissue that you have," Dr. Syed adds.

“In general, we like to see PSA levels below four, but the interpretation depends on a patient’s age and overall risk,” Dr. Syed says. “Some men can develop prostate cancer even with a relatively low PSA, which is why screening decisions should be individualized and discussed with a physician.” 

If you have a strong family history of prostate cancer, you may need to start PSA testing at a younger age. “Current guidelines recommend discussing PSA screening as early as age 40 to 45 for men with higher-risk features, including a family history of prostate cancer, African ancestry or certain inherited genetic mutations.”

Inherited mutations such as BRCA1 or BRCA2 can increase the risk of developing prostate cancer, among other cancers, and can be passed down from parent to child. So, knowing your family history and if you or your parents have genetic mutations is helpful in assessing your cancer risk, Dr. Syed suggests. 

Doctors might also use genomic testing, which analyzes the activity of certain genes within a prostate tumor. These tests help determine how aggressive the cancer is likely to be, allowing physicians to tailor treatment to each patient.

“In some cases, genomic testing helps us safely avoid unnecessary treatments,” Dr. Syed explains. “In others, it tells us when we should treat more aggressively to give the patient the best chance of cure.” 

New and improved ways to diagnose, treat prostate cancer

The OSF HealthCare oncology program has several advanced technologies that help detect prostate cancer earlier and treat it more precisely, often with fewer side effects.

“One of the biggest advances we’ve seen in prostate cancer care is the ability to combine better imaging with more targeted treatments,” Dr. Syed says. “That allows us to detect cancer earlier and personalize treatment, so patients get exactly what they need.”

One example is the multiparametric MRI (mpMRI), an advanced imaging test that provides a highly detailed look at the prostate. This scan can identify suspicious areas that may not be visible on standard imaging, helping doctors detect prostate cancer earlier and guide more targeted biopsies and treatment.

Another breakthrough is PSMA PET/CT, an advanced scan that can detect extremely small amounts of prostate cancer throughout the body. Because it is far more sensitive than traditional imaging, it helps doctors locate recurrent or metastatic disease earlier and plan treatment more accurately. 

OSF HealthCare also offers proton therapy at OSF HealthCare Cancer Institute in Peoria. Proton therapy is an advanced form of radiation that allows physicians to deliver radiation to the tumor while reducing exposure to nearby organs such as the bladder and rectum. 

"With proton therapy, we can often reduce the dose to surrounding healthy tissues compared with conventional radiation," Dr. Syed explains. "That can translate into fewer long-term side effects and better preservation of quality of life for many patients." 

Another highly advanced option available at OSF is high-dose-rate (HDR) brachytherapy, which delivers radiation from inside the prostate.

“HDR brachytherapy is one of the most precise forms of radiation therapy available for prostate cancer,” says Dr. Syed. “Because we deliver radiation from inside the prostate itself, we can sculpt the radiation dose very tightly around the tumor while minimizing exposure to nearby organs like the bladder and rectum. At OSF, this treatment is typically completed in just two sessions, which allows us to deliver a very powerful and focused treatment over a short period of time while maintaining excellent cure rates.” 

Together, these advanced tools allow the OSF oncology team to diagnose prostate cancer earlier, personalize care and deliver highly effective treatment while minimizing side effects. 

Radiation versus surgery: Is there a better option?

In terms of radiation versus surgery, Dr. Syed says they are both highly effective treatment options.

"In terms of cancer control, surgery and radiation have very similar success rates for most patients," says Dr. Syed. "The choice often comes down to differences in side effects and what best fits a patient's lifestyle and priorities."

Rectal irritation, like diarrhea and looser stools during treatment, and other side effects are possible during radiation, but that improves over time, Dr. Syed points out. 

Side effects from surgery include temporary erectile dysfunction (ED), which is regained after surgery. As well as urinary incontinence (accidental urine leakage caused by lack of bladder control), which can tend to last post-surgery as well. Men are encouraged to wear supporting underwear (Depends) to prevent urinary leakage. 

The best starting point is a conversation with your oncology team to discuss what your lifestyle looks like.

If you are actively working and can't have urinary incontinence, radiation will likely be the recommendation. If you have urinary issues already, there are certain radiation options that would be better for you. 

Exercise helps decrease your risk of cancer. Dr. Syed recommends maintaining a healthy weight and staying up to date with your health maintenance and primary care provider, as well as avoiding alcohol and smoking.

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