New Prostate Cancer Treatment Options You Should Know About, From a Urologic Surgeon

The American Cancer Society projects that in 2025, the United States will see approximately 313,780 new cases of prostate cancer—and about 35,770 deaths from the disease. Given that prostate cancer ranks as the second-leading cause of cancer-related deaths among American men, after lung cancer, there is an understandable focus on the availability of new treatment options and the potential for a complete cure with these methods.

Vipul R. Patel, MD, FACS, a board-certified urologic surgeon and medical director of the Global Robotics Institute at AdventHealth offers a hopeful outlook: “Prostate cancer is often highly curable with early diagnosis and treatment. We know that early testing leads to early detection of prostate cancer.”

For this reason, Dr. Patel, who is also known for performing more robotic surgeries than any other surgeon worldwide—including over 16,000 robotic prostatectomies (surgery to remove some or all of the prostate gland)—strongly encourages patients to discuss prostate cancer screening options with their healthcare provider, as early detection significantly improves treatment outcomes.

The American Urological Association (AUA) recommends a baseline prostate-specific antigen (PSA) test for those between 45 and 50 years old and suggests earlier screenings for individuals at increased risk, such as those who are Black or have a “strong” family history of prostate cancer.

For patients with advanced or metastatic prostate cancer—where the disease has spread beyond the prostate—Dr. Patel says, “Achieving a complete cure becomes more difficult.” Although emerging treatments such as hormone therapy, chemotherapy, immunotherapy, and targeted therapy can help manage the disease, they may not eradicate all cancer cells. In such instances, the treatment strategy shifts toward managing the cancer as a chronic condition, aiming to extend and preserve quality of life. Lifestyle factors such as diet, exercise, and stress management can also play a role in optimizing treatment outcomes and improving overall health.

Ahead, Dr. Patel shares new treatment options for prostate cancer you should know about—and offers a peek into the latest research that is revolutionizing prostate cancer diagnosis.

New prostate cancer treatment options

Over the past five years, advancements in prostate cancer treatment have been specifically aligned with the type of prostate cancer diagnosed in patients:

• Localized prostate cancer: This type is confined solely to the prostate.
• Advanced prostate cancer: In these cases, the cancer has spread beyond the prostate. According to Dr. Patel, the treatment focus here is to “help prolong survival and improve outcomes for patients.”

Localized prostate cancer

Robotic surgery

“Robotic surgery to remove the entire prostate has now become the gold standard for treating clinically significant localized prostate cancer,” says Dr. Patel. This technique is the most prevalent surgical method for prostate cancer in the U.S. It offers several advantages over traditional open surgery, including:

• Reduced bleeding during the operation
• Shorter hospital stays
• Faster recovery times for patients

These advantages occur in large part because the surgeon is able to calibrate and customize the robot’s approach to the patient’s unique anatomy. Throughout the procedure, the surgeon is controlling the robot’s parts, which acts as the doctor’s “hands”—just tinier. This usually means minimal invasiveness, the smallest incisions possible, and direct, targeted precision.

Focal therapy techniques

In recent years, focal therapy methods like high-intensity focused ultrasound (HIFU) and cryotherapy have drawn increasing attention. These techniques specifically target cancerous sections of the prostate, preserving the rest of the gland.

Despite their growing popularity, the AUA cautions that the long-term effectiveness of these focal therapies has yet to be extensively studied, and consequently, there is a reluctance to widely recommend these treatments until more data is available.

Advanced prostate cancer

Precision medicine

Precision medicine is transforming prostate cancer treatment by using genomic testing and molecular profiling to personalize care. Genomic testing identifies specific gene mutations in a patient’s tumor, while molecular profiling examines broader genetic characteristics. Together, these advanced tools allow doctors to design treatment plans that target the unique biology of each cancer.

One promising example is radioligand therapy with Pluvicto, often described as working like a “guided missile” against prostate cancer cells. Radioligand therapy combines a targeting molecule with a radioactive particle. The targeting part locks onto prostate-specific membrane antigen (PSMA) receptors—proteins commonly found on prostate cancer cells—while the radioactive part delivers a precise dose of radiation that damages and kills those cells, sparing most nearby healthy tissue.

Pluvicto is given as an intravenous (IV) infusion, meaning the medication is delivered directly into the bloodstream through a vein over a set period of time. Before receiving it, patients undergo a PSMA PET scan to confirm their tumors carry enough receptors for the therapy to work.

The FDA has approved Pluvicto for advanced prostate cancer that no longer responds to hormone therapy or chemotherapy, and clinical trials show it can slow disease progression, extend survival, and improve quality of life for men with few remaining treatment options.

Targeted hormone therapies

Prostate cancer is driven by male sex hormones, primarily testosterone. Dr. Patel points out that newer targeted hormone therapies, such as enzalutamide (Xtandi) and abiraterone (Zytiga), have proven effective in treating advanced prostate cancer. These therapies work by “specifically targeting molecules involved in the cancer’s growth,” offering a more focused approach to slow the disease’s progression.

Multidisciplinary approach

The management of advanced prostate cancer has evolved into a collaborative effort. “It is now common for a combination of treating doctors—including urologists, radiation oncologists, and medical oncologists—to be involved in their care,” explains Dr. Patel. This integrated approach ensures that each patient’s needs are met, aiming for the best possible outcomes.

Prostate research progress

There is new research that promises to transform prostate cancer care. Dr. Patel shares a few developments:

• MRI-guided prostate biopsy: This technique uses MRI imaging to enhance the accuracy of prostate biopsies, reducing the risk of overlooking clinically significant tumors.
• Liquid biopsies: These non-invasive tests analyze blood or urine for circulating tumor cells or other biomarkers, offering insights into prostate cancer detection, disease progression, tumor genetics, and treatment response.
• Artificial intelligence (AI): Dr. Patel’s team utilizes AI to analyze surgical videos, predict post-surgery outcomes, and improve the interpretation of MRI images for better prostate cancer detection. AI proves essential in identifying subtle patterns in imaging that might be overlooked by the human eye and can lead to better treatment planning.

For more wellness updates, subscribe to The Healthy by Reader’s Digest newsletter and follow The Healthy on Facebook and Instagram. Keep reading:

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