What is the best prostate cancer treatment for me?

Published: Tuesday, April 11, 2023
Radiation Oncology
Radiation Oncology

Nobody wants to be told they have prostate cancer. Thankfully, the list of treatment options have never been better for prostate cancer patients.

What Kind of Treatments Are Available?

There are several treatment options for localized prostate cancer that has not spread outside of the prostate gland. The following are the common treatment options for management of localized prostate cancer: 

  • Active surveillance
    For some men with low-risk prostate cancer, active surveillance may be an appropriate option. This involves closely monitoring the cancer with regular PSA tests (a simple blood test), digital rectal exams, and imaging studies, with the goal of delaying treatment until the cancer shows signs of progression. Some men avoid treatment entirely if their cancer does not become larger or faster growing.
  • Surgery
    Radical prostatectomy is a surgical procedure that involves removing the entire prostate gland and some surrounding tissue.  
  • Radiation therapy
    Radiation therapy uses focused high-energy radiation to kill cancer cells and shrink tumors. It can be delivered using x-rays directed from outside the body into the prostate or an implant of radioactive material into the prostate, or a combination of both.  
  • Hormone therapy
    Hormone therapy can be used alone or in combination with other treatments to shrink the prostate gland and slow the growth of prostate cancer. It works by reducing the levels of male hormones, such as testosterone, which can stimulate the growth of prostate cancer cells. 

Each treatment option has its own benefits and risks, and the choice of treatment depends on several factors, including the patient’s individual situation and treatment goals. Patients should discuss the potential benefits and risks of each treatment option with their radiation oncology physician to make an informed decision about their treatment plan. It is best to meet with both a urologist (a surgeon who performs radical prostatectomy) and a radiation oncologist (who delivers radiation treatments) to understand all these treatment options.

Advanced Radiation Therapy Treatment Options

Radiation therapy is a common treatment option for prostate cancer with cure rates equivalent to surgery. It involves the use of focused high-energy radiation to kill cancer cells and shrink tumors while sparing surrounding normal organs to minimize side effects.

There are several types of radiation therapy used to treat prostate cancer, including:

External Beam Radiation Therapy (EBRT)

This involves delivering high energy x-rays (called photons) radiation to the prostate gland from outside the body using a machine. EBRT can be delivered using different techniques, including:

  • Intensity-modulated radiation therapy (IMRT)
  • Volumetric modulated arc therapy (VMAT)
  • Stereotactic body radiation therapy (SBRT)

Each technique uses slightly different methods to deliver radiation to the prostate gland while minimizing the radiation dose to surrounding healthy tissues, such as the bladder and rectum. Image guidance is used to ensure that the prostate is accurately targeted each day before radiation is delivered, most commonly with a cone-beam CT (CBCT) scan.

Prostate markers (fiducials) or a gel spacing device (called SpaceOARTM) may be used to help guide the treatment and reduce radiation dose to the rectum. 

Proton Therapy vs. X-Rays

Proton therapy also uses external delivery radiation but uses protons instead of x-rays. The cure rates and side effects with photon or proton radiation are the same.


Brachytherapy is a type of radiation therapy that involves the insertion of small radioactive materials into the prostate gland. The radioactive material releases radiation over time, killing cancer cells while minimizing damage to surrounding healthy tissues. Brachytherapy can be performed in two ways:

  • A permanent implant using low dose rate (LDR) brachytherapy involves a procedure where the radioactive “seeds” are left in place forever. The patient is radioactive at a low level for a period of time.
  • A temporary implant using high dose rate (HDR) brachytherapy involves a procedure where a radioactive source is placed in the prostate for a short period of time and then removed. The patient is not radioactive after the procedure.

Just like external beam radiation, a gel spacing device (called SpaceOARTM) may be used to help guide the treatment and reduce radiation to the rectum. 

How long does this treatment take?
Brachytherapy is typically performed over one or two days. It is sometimes used alone or in combination with external beam radiation therapy, depending on the patient.

Learn More about NGMC Cancer Services

Northeast Georgia Health System is proud to offer the latest technology and advanced radiation therapy treatment options. Radiation therapy treatments are available at our Braselton, Gainesville, and Toccoa locations. Your board-certified radiation oncology physician will help guide you through the various radiation treatment options and help you decide which treatment is best for you.