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Cancer Institute Medical Services University Prostate and Urology Cancer Center Prostate and Urology Services
Prostate and Urology Services
Your treatment plan may include surgery, radiation therapy, chemotherapy, immunotherapy or a combination of any of these. At the University Prostate and Urology Cancer Center, the following management and treatment options are made available by our team of experts.
- Standard or “open” surgery
- Minimally invasive surgery (laparoscopic & endoscopic)
- Nerve-sparing prostatectomy
- Bladder reconstruction surgery
- Robotic surgery with the da Vinci Surgical System
- External beam radiation including IMRT and IGRT
- Radiosurgery with the CyberKnife Radiosurgery System
- Brachytherapy
Chemotherapy
Immunotherapy
Hormonal Therapy
Radiofrequency Ablation
Cryotherapy
Clinical Trials
Surgery is defined as the removal of tissue by your surgical team using a scalpel/sharp knife or other cutting instruments.
- Standard or “open” surgery - Standard or open surgery is commonly performed and involves the excision of cancer tissue in the operating room. The advantages of open surgery allows for successful treatment when your medical team is dealing with a large and complicated cancer.
- Minimally invasive surgery (laparoscopic & endoscopic) - In contrast to “open” surgery, minimally invasive surgery, involves several small incisions (ports) close to the abdominal or pelvic cavities. Within the small incisions, a laparoscope instrument is inserted with a video camera and a light source. Other tools can be inserted through other incisions to drain the bladder or organs as well as taking tissue samples. Laparoscopic procedures are minimally invasive thus reduce the recovery period as well as the risk for infection.
- Nerve-sparing prostatectomy - Nerve-sparing prostatectomy is another laparoscopic procedure in which the nerves that run close to the prostate are left intact while the prostate tissue is cut away and removed.
- Bladder reconstruction surgery - The goal of bladder reconstruction surgery is to restore urinary function once the cancerous bladder tissue has been removed (cystectomy). The procedure also is known as urinary diversion and is performed in 3 different techniques.
1.) Ileal Neobladder is a technique where the tissue is taken from the small intestines to form the new bladder.
2.) Ileal Conduit is a simple technique where a small piece of tissue is used to connect ureters to the surface of the skin at the navel. The urine is then drained into a urostomy bag.
3.) Continent reservoir is the most difficult option to perform surgically . It involves using part of the small intestine tissue to create a pouch to collect urine which is connected to the navel. The pouch is drain by a catheter into a urostomy bag.
- Robotic surgery with the da Vinci Surgical System - The da Vinci Surgical System is the latest in surgical technology providing an alternative to traditional open surgery and laparoscopy for some cases such as prostatectomy. Surgeons can now operate using only 1-2 cm incisions but with greater precision and control than ever before. Robotic surgery can minimize the pain and risk associated with surgery while increasing the likelihood of a fast recovery and excellent clinical outcomes. The da Vinci robot requires that every surgical maneuver be performed by your surgeon who is in control during the entire surgery.
Radiation therapy is one of the three major ways cancer is treated. Radiation therapy contains two sub-classes: Internal Radiation Therapy and External Radiation Therapy.
- Internal radiation therapy uses catheters, wires, seeds or sealed needles that are inserted directly into or close to the cancerous tissue .
- During external radiation therapy, a beam of radiation is directed through the skin into the tumor to destroy the cancer cells. This therapy is usually delivered daily over a period of weeks depending on the type of cancer.
Types of external radiation therapy include the following.
- External beam radiation including IMRT and IGRT - This therapy aims radiation directly to the cancerous tissue. EBRT delivers radiation from a source outside the body. A machine called a linear accelerator rotates around the tumor sending radiation beams at many directions to the tumor.
1. Intensity Modulated Radiation Therapy (IMRT) is a specialized form of radiation treatment where the radiation dose is designed to conform to a three-dimensional (3-D) shape of the tumor. The radiation beam can be broken in “beamlets” so the intensity of each beamlet can be adjusted individually. IMRT focuses a high radiation dose to the tumor while minimizing radiation exposure to surrounding normal tissues.
2. Image Guided Radiation Therapy (IGRT) This therapy uses ultrasound, electronic imaging or CT technology to pinpoint the tumor location daily before each treatment. This technology allows our team to make adjustments to the treatment region when there is movement such as breathing or digestion movement. High-resolution three-dimensional images help guide therapy to the tumor site. - Radiosurgery with the CyberKnife Radiosurgery System - CyberKnife combines advanced robotics and missile-guidance technology to pinpoint the position of tumors and delivers highly focused beams of radiation without damaging surrounding tissue. CyberKnife also called “stereotactic radiosurgery” uses accurate targeted doses of radiation to treat tumors, lesions and a few other select medical disorders.
Types of internal radiation therapy
- Brachytherapy - Delivers a highly concentrated dose of radiation near or in the tumor, while sparing the surrounding healthy tissue. Also called, radiation implant or a radioactive source. It may be used alone or in combination with other radiation therapy procedures. Brachytherapy treatment may be delivered in the form of small seeds (such as prostate seed implants) or wires that are placed inside the tumor (HDR). Brachytherapy may be delivered in a high dose or a low dose. The dose of radiation through brachytherapy depends on the size of the tumor, location and the sensitivity to radiation.
Chemotherapy is the use of drugs to kill or stop the growth of cancer cells. The type of chemotherapy used is dependent on the type and stage of cancer. Chemotherapy may be delivered by injection or through an IV and some forms can be taken orally.
Immunotherapy / Biological Therapy Immunotherapy or biological therapy is a type of treatment that works with your immune system. It can help fight cancer or help control side effects (how your body reacts to the drugs you are taking) from other cancer treatments like chemotherapy. There are various methods of therapies such as monoclonal antibodies, cancer vaccines and growth factor for blood cells. Hormonal TherapyHormonal therapy is a type of cancer treatment that involves decreasing hormones or suppression of their actions, which in turn, stops the growth of cancerous cells. In prostate cancer, for example, androgen located in the testis is responsible for the growth of prostate gland. Hormonal therapy does not cure prostate cancer, but it is used in several instances such as: when the cancer has spread beyond the prostate gland, or when the cancer remains after surgery and radiation.
Radiofrequency AblationRadiofrequency ablation (RFA) is performed to treat tumors in the kidney. Once the diagnosis of tumor is confirmed, a needle-like probe is placed inside the tumor. The radiofrequency waves passing through the probe increase the temperature within the tissue resulting in the destruction of the tumor. The decision to use RFA is based on multiple factors. RFA procedures are performed under image guidance (CT scan or ultrasound) by an interventional radiologist. The decision to use RFA is based on multiple factors.
CryotherapyCyrotherapy or cryosurgery is a procedure in which tissue is frozen to destroy cancer cells. This is usually done with a special instrument that contains liquid nitrogen or liquid carbon dioxide.
Clinical TrialsClinical trials are research studies in which people help doctors find ways to improve health and cancer care. Each study tries to answer scientific questions and to find better ways to prevent, diagnose, or treat cancer. A number of clinical trials are offered for patients with urological cancers. Many include the study of new drugs to treat cancer.