There are a variety of treatment options available to patients who have been diagnosed with prostate cancer. Here at UCLA, the course of treatment is individualized to each patient’s cancer grade and stage as well as current state of health. The management of prostate cancer requires extensive collaboration.
The Institute of Urologic Oncology at UCLA and the Department of Urology’s long-standing Prostate Cancer Program have a multi-disciplinary team that specializes in prostate cancer treatment and offers a number of innovative options. Bi-weekly conferences are held and attended by specialists including urologists, medical oncologists, radiation oncologists, pathologists, radiologists, and clinical trial nurses. This provides a forum with diverse, specialized perspectives for deciding upon the best option for each individual patient.
Integrated Cancer Program
The Institute of Urologic Oncology – Integrated Cancer Program provides newly diagnosed urologic oncology patients the opportunity to meet with renowned cancer specialists at UCLA – in the fields of Urologic Surgical Oncology and Radiation Oncology - on the same day in the same clinic.
Advanced prostate cancer occurs when a tumor that develops in the prostate gland spreads outside the prostate. The most common sites of prostate cancer spread are to the lymph nodes and bones. This is also called metastatic prostate cancer. Currently, no treatments can cure advanced/metastatic prostate cancer. However, there are effective ways to help slow its spread, prolong life, and control its symptoms. Read more about:
A wide variety of treatments are used for prostate cancer, depending on the stage of the disease, the patient’s age and overall health, and patient preferences or concerns about potential risks and side effects such as erectile dysfunction, urinary incontinence, and other bladder or bowel problems. For early-stage disease when remaining life expectancy is at least 10 years, prostate cancer surgery is often the preferred option. For most men, this means a nerve sparing radical prostatectomy, in which the prostate is removed while, in most cases, potency is preserved.
Increasingly, this prostate cancer surgery procedure is now done robotically: This minimally invasive prostate cancer surgery shortens hospital stay and may shorten recovery time, while achieving comparable results to traditional open surgery. At UCLA, robotic instruments have been introduced for prostate cancer surgery to improve surgical precision. Prostate cancer treatment options >
Robotic Procedure - Minimally Invasive (laparoscopic) Prostatectomy
For many men with early-stage prostate cancer, the robotically assisted minimally invasive prostatectomy has emerged as an attractive option. UCLA physicians are achieving results that are equivalent to the traditional open surgical approach to nerve sparing radical prostatectomy in terms of eliminating cancer and preserving sexual potency and urinary continence for many early-stage prostate cancer patients. Surgeons are able to obtain pictures of the surgical site with 15-fold magnification, and insert miniaturized instruments to remove the prostate. The introduction of robotic instruments has helped to improve surgical precision. Surgeons are able to sit in a console with a three-dimensional view inside the patient and move three robotic arms with the full natural range of motion, while a fourth robotic arm controls the camera. The instruments can act like human wrists, giving surgeons greater flexibility as they use the robot to manipulate the tiny surgical tools inside the body. The minimally invasive approach offers the advantages of shorter hospital stay and recovery time and less blood loss. Minimally invasive options >
UCLA Urology robotic surgeons have been offering outpatient (also known as same-day) prostatectomy since 2011 for qualified patients. Men are discharged home the same day of surgery instead of remaining overnight in the hospital. Outpatient, or same-day, prostatectomy is particularly suited for young men without any prior health conditions.
Robotic prostatectomy at UCLA >
Outpatient (same-day) prostatectomy at UCLA >
Nerve Sparing Prostatectomy | New Strategies for "Open" Surgeries
For some patients, the nerve-sparing radical prostatectomy continues to be the best option. In the hands of experienced surgeons, this "open" operation is highly effective in removing the cancer and preserving potency. UCLA's database of the results of more than 1,400 patients treated with the surgery at UCLA indicates that 80%-90% of patients under the age of 60 regain their sexual function, with a 5%-10% risk of stress urinary incontinence after one year. Recovery time has been reduced to one and a half days, with catheterization averaging seven days and patients returning to regular activities in as little as two to four weeks. UCLA doctors have adopted new strategies in an effort to improve nerve-sparing abilities for surgical patients. During the open procedure, patients with bulkier tumors and aggressive cancers receive real-time pathology evaluation by the surgeons who obtain frozen sections when necessary to better facilitate decisions on preserving the nerves. Medications such as Viagra are being given to prostate cancer patients both pre- and postoperatively to enhance potency rehabilitation. Nerve sparing prostatectomy >
Early-stage prostate cancer can also be successfully treated with prostate radiation therapy - the use of high-energy rays delivered by external beam, or, more recently, by radioactive seeds implanted into the prostate under ultrasound guidance, which then emit high doses of radiation exclusively to the prostate over the course of several months (brachytherapy). For patients with early-stage prostate cancer in whom radical prostatectomy or radiation is not a good option, cryoablation is a minimally invasive procedure that destroys the cancer cells by rapidly freezing and thawing the cancerous tissue. Still others, particularly older patients, choose an "active surveillance" approach in which there is no immediate treatment but the tumor continues to be closely monitored. Non-surgical and prostate radiation therapy >
New types of treatment are also being tested in Clinical Trials.
Pelvic Floor Rehabilitation
When you have prostate cancer surgery or prostate cancer radiation treatment the muscles that help you control your urine flow may be weakened. The good news is that there is a simple exercise called a Kegel (Key-gul) exercise, you can do to help strengthen your muscles. Pelvic floor >
Radical prostatectomy is a major surgical procedure and often patients with prostate cancer are in an age group with other medical problems. At UCLA, we have an excellent support structure to help patients before, during, and after your surgery. In addition to our surgical team, an internal medicine hospitalist service routinely follows all our prostate cancer patients following surgery and is available to see patients before surgery to get acquainted with some of our more complicated cases. We have well-trained nurses on the ward and intensive care unit, a pain service team headed by anesthesiologists, stoma nurses, social workers, physical therapists, and nutritionists.