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Prostate Cancer

The prostate cancer team at Vanderbilt-Ingram Cancer Center has one goal: treat your cancer with as little disruption of your life as possible. From diagnosis and second opinions to the latest and most precise treatments, we focus on personalized care that considers what matters to you most.

Prostate tumors usually grow slowly. From cancer caught early to advanced and complex disease, there are many effective treatments available. Most men have time to carefully consider all their options and choose the course of action that is right for them. 

Screening for prostate cancer may benefit many men. We encourage you to learn more about prostate cancer screening and to talk to your doctor.

Prostate Cancer: Why Choose Vanderbilt-Ingram

At Vanderbilt-Ingram, you will find:

  • An experienced team focused on you: Our team of prostate cancer specialists are among the most experienced in the country. We bring together experts known for their national and international leadership in prostate cancer. Our team understands and offers an entire range of possibilities. They work together to develop treatment designed to meet your needs and concerns.
  • The latest and most accurate technology: Our tools include some of the most innovative ways to destroy cancer and limit side effects. Our approach begins with very accurate image-guided biopsies. We offer the most precise radiation therapy in as a little as one to five days. Our surgeons use robotic surgery as other sophisticated techniques. We offer the latest drug therapies, including a cancer vaccine.
  • Collaborative care: Having your care providers together is not only more convenient, it can mean better care. Our experts meet regularly to discuss complex cases and work together to develop the most effective treatment plans. At a comprehensive cancer center like Vanderbilt-Ingram, you’ll have access to other specialists. For example, if your treatment may affect your heart, we’ll assign you a specialized cardiologist to help keep your heart healthy during treatment. 
  • Expert second opinion: Men diagnosed or treated elsewhere often seek a second opinion from our specialists, who are known across the country and around the world for research and leadership in prostate cancer. In fact, as members of the National Comprehensive Cancer Network, our experts help develop the guidelines that cancer doctors across the country follow.
  • Clinical trials: The National Cancer Institute designates Vanderbilt-Ingram as a Comprehensive Cancer Center. This recognizes the center’s leadership in research, including patient studies in prostate cancer. These “clinical trials” give you access to promising options before they are available elsewhere.

Prostate Cancer: An Accurate Diagnosis

Prostate cancer may be suspected because of symptoms, including urination problems, blood in the urine or semen, or pain when urinating or pain in the back, hips or pelvis that doesn’t go away. A blood test, called the PSA test, may also suggest prostate cancer.

Health issues other than cancer may cause these symptoms or high levels of PSA, which stands for prostate specific antigen. If you’ve been told you may have prostate cancer, the first step is to get an accurate diagnosis. It is important to do this with a team of experts who specialize in prostate cancer and work together. This team should include specialists in surgery, radiation therapy, oncology and pathology.

You’ll also want a team with access to the latest technology to make sure diagnosis. This will help make sure the diagnosis is accurate, which is the foundation for the best treatment plan.

The first step in diagnosis is usually a biopsy. A surgeon removes very tiny tissue samples from different areas of the prostate. 

Vanderbilt-Ingram Cancer Center offers the most sophisticated technology to diagnose prostate cancer, 3-D MRI fusion targeted biopsy. This technique combines 3-D images with real-time ultrasound imaging, magnetic resonance imaging (MRI), and robotics. The surgeon can “see” the areas where cancer is most likely to be and aim the biopsy there. This increases accuracy and reduces the chances of a “false negative.” A false negative occurs when results that say there is no cancer even though there are cancer cells that have been missed. It also reduces side effects from the biopsy.

If cancer cells are found, Vanderbilt-Ingram’s team may do special tests to predict how likely the cancer is to grow and spread. Most prostate cancers grow slowly. A more quickly growing tumor may be called “aggressive.” These “genetic biomarker” tests look for changes in genes that make cancers more aggressive. This information is used to decide whether aggressive treatment is warranted. It may also help men avoid repeat biopsies or unnecessary treatment.

Prostate Cancer Treatment at Vanderbilt-Ingram

Today, there are many effective treatments for prostate cancer. Each has its own benefits and risks. Working with an expert team of specialists, like the one at Vanderbilt-Ingram, allows you to choose what’s best for you. The right treatment will consider details about your cancer, including how aggressive it may be. It also considers other important things like your overall health, your age, your lifestyle, and the demands of your job or hobbies. It all comes down to what matters most to you.

  • Active surveillance: Remember, most prostate cancers are detected at an early stage. Many prostate cancers grow slowly and pose less threat. Treatments like surgery or radiation are effective and better than ever. But they are not without important side effects that you should discuss with your doctor. Depending on how aggressive a tumor is, many men opt for “active surveillance.” Active surveillance doesn’t mean “doing nothing.” It means watching the cancer very closely so that swift action can be taken before the cancer shows any signs of growing or causes other problems. It includes blood work, testing the tumor’s DNA to understand what is making the cancer grow and biopsies, often every two or three years.
  • Surgery: Surgery to remove the prostate may be the right treatment for you. Some centers like Vanderbilt-Ingram often use robotic surgery to treat prostate cancer. In this approach, the surgeon controls the robot to remove the cancer. Traditional “open surgery” may be needed. However, if robotic surgery is appropriate, it can mean smaller incisions, faster recovery and other benefits. Research shows that centers that perform the most surgeries have better outcomes. You can rest easy knowing that Vanderbilt’s urology team is one of the most experienced prostate surgery centers in the United States. 

    Surgeons may also use methods to kill the tumor without removing the prostate gland. This may include using very cold gas to freeze the gland (cryoablation or cryotherapy). Another technique, called high-intensity focused ultrasound (HIFU), uses ultrasound waves to heat up the prostate gland to kill prostate cancer cells. In addition, Vanderbilt-Ingram is starting to test cryotherapy and HIFU in a very focused way that kills only the tumor cells, not the entire gland. This is sometimes compared to a “lumpectomy” for breast cancer. 
  • Radiation therapy: Radiation can be used to kill cancer cells. There are different ways to deliver radiation. Which is best for you depends on the size, location, type and stage of your tumor. Vanderbilt-Ingram offers the latest and most precise radiation therapy, which may be delivered in as few as one to five treatments. This delivers the most cancer-killing dose to the tumor cells. Healthy tissue is not harmed, so side effects are reduced. We also offer a new technique, called a “hydrogel spacer,” that helps protect the rectum. We offer radiation therapy in several locations in Middle Tennessee. Depending on the type of radiation that is best for you, you may be able to find care closer to home.
    • Intensity-modulated radiation therapy (IMRT): Called IMRT for short, this type of radiation can be carefully customized to the shape and size of the prostate. It can deliver cancer-killing doses of radiation to the prostate while avoiding healthy tissue. It is now considered the standard of care, meaning it’s the best practice for treating prostate cancer. 
    • Image-guided radiotherapy: Called IGRT for short, this approach takes IMRT and adds real-time imaging with X-rays or CT scans to aim radiation at the prostate even more precisely. It also protects nearby tissue from much of the radiation.
    • Stereotactic radiosurgery: “Radiosurgery” refers to the precision of this approach, but it isn’t surgery. It is so precise that it allows delivery of very high doses of radiation with only five treatments. Vanderbilt-Ingram Cancer Center has the expert team to offer this approach. In addition, Vanderbilt is the only center in the region to couple therapy with a special technique to prevent damage to the nearby rectum.
    • Brachytherapy: This treatment places radioactive “seeds” inside the prostate. These seeds deliver a strong dose of radiation to the prostate. They have little impact on healthy cells near the tumor. The seeds are left inside the prostate. Over time they stop giving off radiation. Our expert team of radiation oncologists, physicists, and urologists have the specialized skill to perform this treatment in one day to get you back on your feet quickly. 
    • Photons vs. protons: Photons and protons are types of particles that produce radiation that can be used to kill cancer cells. Vanderbilt-Ingram Cancer Center uses photon beam therapy. Proton beam therapy is a more expensive technology. Studies have not shown it to be more effective against prostate cancer. Proton therapy generally performed over many weeks in contrast to the shorter photon courses we may provide. Insurance plans vary in whether they cover proton beam therapy.
    • Injectable radiation: Advanced prostate cancer may spread to bones. Vanderbilt-Ingram offers an injectable form of radiation. This treatment is marketed as Xofigo. It helps control the growth of prostate cancer cells in bones.
  • Chemotherapy: Chemotherapy uses strong drugs to fight cancer cells. This may involve pills taken by mouth or, more commonly, infusion into a vein in a clinic setting. You may have heard about nausea and other side effects of chemotherapy. Today, we have medicines to use at home that prevent or reduce side effects. These have greatly improved quality of life during cancer treatment. We offer cancer infusion therapy in several locations in Middle Tennessee, so you’ll be able to find care closest to you.
  • Hormonal therapy: Male sex hormones (testosterone and other androgens) may encourage growth of prostate tumors. Hormone therapy to block that action may be used. 
  • Cancer treatment vaccine: We were the first center in the Southeast to use a cancer treatment vaccine, marketed as Provenge. This treatment helps activate the body’s immune system to fight prostate cancer that has spread to other organs.​ 
  • Clinical trials: Before new cancer treatments become widely available, they are tested in clinical trials. We encourage anyone with a cancer diagnosis – even if their cancer is caught at an early stage to ask if a clinical trial may be right for them. In cancer clinical trials, you will always receive a standard treatment if one is available for your situation. You may also receive a promising therapy that could be better. At Vanderbilt-Ingram Cancer Center, we have hundreds of trials available. We have a team of experts in developing and offering clinical trials. And we have staff to guide you through the process and help connect you to trials that are right for you. Call (800) 811-8480 for more information about clinical trials at Vanderbilt-Ingram.

Support After Treatment Ends

The end of cancer treatment can bring relief for patients and their families. It also can be a time of new concerns. You may have concerns about physical, emotional or practical issues related to your cancer or its treatment. Cancer survivors who are doing well may have questions about how to maintain well-being going forward.

Vanderbilt-Ingram Cancer Center offers a dedicated resource to meet these needs. The REACH for Survivorship program is for cancer survivors, regardless of age, type of cancer, how long ago they were treated or where they received their cancer care. 

You’ll receive a full range of follow-up care to meet your individual needs. You’ll leave with a personalized Cancer Survivorship Care Plan that will be your roadmap for health and well-being.

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