Prostate Cancer | Treatment Program Options | MedStar Health
Dr Sean Collins talks with a patient who is laying on the bed of the cyberknife at MedStar Georgetown University Hospital.

Overview

As one of the most experienced teams in the region, we can help you find the prostate cancer treatment that’s right for you.

Prostate cancer is one of the most common cancers among men, with nearly one in six developing the disease at some point in their lives. Thankfully, most men are diagnosed early, with a range of safe and effective treatments that offer excellent outcomes with fewer long-term side effects.

At MedStar Health, your care team involves experts across various specialties, many of whom are well-known for making a difference in outcomes for men with prostate cancer. Here, you'll find the latest technology and techniques in robotic and minimally invasive surgery, radiation, and medical oncology under the guidance of some of the most experienced surgeons and oncologists in the Washington, D.C., and Maryland region. Your care team also consists of nurses, social workers, genetic counselors, nutritionists, and others working together to support you and your family as you journey back to health.

Through our partnership with the only National Cancer Institute-designated comprehensive cancer center in the Washington, D.C., region, the Georgetown Lombardi Comprehensive Cancer Center, you'll benefit from innovative research and clinical trials paving the way for better, more personalized therapies that offer hope for a cure. We're proud of our unmatched experience, but more importantly, we're honored to treat you with the dignity, respect, and compassion you deserve.

Symptoms and risk factors

In the early stages, there are no noticeable symptoms of prostate cancer.

Prostate cancer grows slowly, and many people don't have symptoms in early stages. As prostate cancer progresses, the disease can cause:

  • Urination problems, such as pain, burning, difficulty stopping or starting, weak flow, and/or increased frequency
  • Blood in the urine or semen
  • Frequent pain in the lower back, hips, or upper thighs
  • Difficulty getting or maintaining erections
  • Painful ejaculation
  • Loss of appetite or weight
Other conditions, such as infection or prostate enlargement, can also cause these symptoms. If you experience any symptoms, it's important to see your primary care doctor or urologist as soon as possible.

Race and family history may affect your risk of developing prostate cancer.

Your risk of prostate cancer increases if you are:

  • 50 or older
  • African-American
  • Closely related to others who have had the disease (like a father or brother)
  • Closely related to several women who have had breast cancer
  • A carrier of a BRCA gene (a genetic mutation commonly associated with ovarian and breast cancers)
  • Obese

If you have a high risk of prostate cancer, it's important to talk to your primary care doctor or urologist about how frequently you should get screened for the disease using a prostate-specific antigen (PSA) test. Because there are more treatment options when caught early, regular screening can detect prostate cancer when it is more easily cured. Our genetic counselors can also help you understand your risk, especially if you have family members who had prostate, ovarian, or breast cancer.

Screening and prevention

There is no one-size-fits-all approach to prostate cancer screening.

Most men will develop prostate cancer in their lifetime. However, it affects every man differently, and many times, it doesn't become life-threatening. In fact, when caught early, the survival rate is over 90 percent. That's why it's always better to know early when you have more treatment options, including active surveillance.

We commonly screen for prostate cancer using a blood test that measures the prostate-specific antigen (PSA) levels. However, elevated PSA levels don't always mean you have prostate cancer, as prostate enlargement and infection can also cause PSA levels to rise.

We also screen patients for prostate cancer using a digital rectal examination (DRE). While a bit uncomfortable, a digital rectal exam allows your provider to feel for any lumps on the prostate. It's a quick and potentially life-saving procedure that plays a vital role in diagnosing the disease.

At MedStar Health, we follow the latest guidelines from the American Cancer Society, the American Urological Society, and others. When and how frequently you should get screened varies based on your risk factors for the disease, so it's important to have conversations about a PSA blood test with your primary care provider or urologist. These conversations should start around 50 and continue through 70 if you have an average risk. However, if you have a high risk based on your family's cancer history or your ethnicity, you may benefit from starting the conversation as early as 40.

 

 
1 in 8 men will be diagnosed with prostate cancer
 

 
3.1 million men in the U.S. are prostate cancer survivors
 

 
100% of men over 50 should discuss their risks with a doctor
 


You can't prevent prostate cancer, but it doesn't have to define your life.

According to the American Cancer Society, some types of cancer can be prevented, but prostate cancer is not among them. There is no sure way to avoid it, as you can't control your age or ethnic origin. However, experts agree that maintaining a healthy lifestyle—controlling weight, eating a healthy diet, and getting regular exercise—may lower the risk of all types of cancers.

Diagnosis

We know that finding your PSA levels are high can cause anxiety and overwhelm. That's why we use advanced detection tools to quickly determine if you have cancer and, if so, how far it has spread.

  • Prostate biopsy: During a biopsy, we collect prostate tissue from the prostate gland using tiny needles. This outpatient procedure is guided by an MRI and helps us to better understand the location, size, and type of tumor you have. We also offer transperineal prostate biopsies, a safer way to perform a biopsy with significantly fewer risks of infection. For cancers that can take a "watch and wait" approach, our unique template biopsies provide a superior active surveillance method.
  • Gleason scores: We can predict how aggressive your tumor is by grading it using a Gleason score. Tumors who score six or below are less likely to spread, while those above seven are more likely to grow.
  • Biomarker profiling: We also use biomarker profiling on your tumor to find specific characteristics that may help determine the type of treatment that will work best and monitor how cancer responds to it.
  • PSMA PET imaging: We also offer an advanced type of imaging, PSMA (prostate-specific membrane antigen) imaging, which detects proteins mainly found in prostate cancer cells. This is the most advanced, FDA-approved type of imaging for prostate cancer, only recently made available in the United States.

Treatments

From the conventional to the cutting-edge, we offer comprehensive treatment options for every case of prostate cancer. If you have slow-growing cancer limited to the prostate gland, we may recommend active surveillance or "watchful waiting." This allows us to delay cancer treatments until it shows signs of growth and require a more invasive approach. When prostate cancer is growing, we'll consider your tumor's location, size, and genetic makeup to design a personalized treatment plan that will be the most effective.

Minimizing and managing any possible side effects, like incontinence and erectile dysfunction, is of the utmost importance. That's why we offer technically-complex robotic surgeries and the latest in radiation and targeted therapies that preserve healthy tissue and nerves. As a result, many men report fewer impacts on their urinary, bowel, and sexual function.

Surgery

Minimally invasive surgery is an effective treatment option for many men under 65. Surgery to remove the prostate gland is called a prostatectomy, a procedure we're skilled in performing robotically. Using the da Vinci robot, our patients benefit from better precision, faster recoveries, and earlier return of urinary continence.

We have some of the most experienced robotic surgeons in the mid-Atlantic region, with over 3,500 robotic cases since 2003. Because we perform a high number of robotic procedures, we're among the top providers in the area to perform prostate cancer surgery. We're proud to offer innovative, minimally invasive treatments, such as:

  • Retzius-Sparing Robotic Assisted Radical Prostatectomy (RARP): This technically challenging procedure involves an alternate route to the prostate, preserving connections to the bladder and urethra to significantly reduce the risk of urinary incontinence after surgery..
  • Athermal Nerve Sparing Robotic Assisted Laparoscopic Prostatectomy (NS-RALP): Used to treat early-stage prostate cancer in sexually active men, this option offers fewer side effects than traditional prostatectomy without compromising outcomes..
  • Cryoablation: This minimally invasive focal therapy procedure uses extreme cold to freeze and kill abnormal cancerous and precancerous cells..
  • High-Intensity Focused Ultrasound (HIFU): This interventional radiology treatment uses "heated" sound waves to kill cancer cells with minimum side effects.

Chemotherapy

Chemotherapy is oral or intravenous medication that helps to fight cancer. Effective chemotherapy drugs are now used in combination with hormonal therapy that may extend survival by causing prostate cancer to regress.

Immunotherapy and targeted therapy

Our researchers and physicians are leading the way in developing innovative therapies that bring new hope to cancer patients. This includes immunotherapy that retrains a patient's immune system to recognize and destroy prostate cancer cells. For example, a new immunotherapy vaccine is the first in a new class of therapies that retrains white blood cells to target and eliminate abnormal cells. Through our partnership with the Georgetown Lombardi Comprehensive Cancer Center, we participated in the groundbreaking clinical trials that led to its approval by the U.S. Food and Drug Administration (FDA).

We conduct genetic profiling on nearly every prostate tumor to understand if it will respond to certain immunotherapy drugs. If we can find specific genetic alterations, we may be able to more effectively attack specific cancer cells in men with metastatic cancer.

Hormone therapy

Hormone therapy is a standard treatment option for men with metastatic prostate cancer or other advanced forms of the disease. Testosterone is the hormone that feeds prostate cancer and can cause it to grow. When we block or suppress testosterone with hormonal therapy, we can stop or reverse the progression of the disease. This makes it an effective option to help you live longer.

Hormonal therapy may also be combined with other treatments, such as radiation therapy. Your medical oncologist will work closely with other members of your care team to determine which treatment(s) are right for you based on where your cancer is located and how quickly it's growing.

Radiation therapy

Our radiation oncologists have an incomparable set of tools to deliver your radiation treatment plan. We were one of the first to offer some of the safest, most effective types of radiation therapy, including CyberKnife and proton therapy using HYPERSCAN™. Our experience using these advanced forms of radiation allows our patients to benefit from the highest level of precision and care.

When radiation therapy is recommended, you can expect us to use the latest technology to deliver the right amount of radiation, at the right dose, for the right length of time. Working closely with urologists, we work hard to limit the chance of side effects to bowel, urinary, and sexual function. Radiation therapy may be used alone or in combination with other treatments, including hormone therapy and/or surgery.

At MedStar Health, your radiation treatment plan will vary based on your unique case and may include:

  • Brachytherapy: This advanced cancer treatment involves placing 100 radioactive sources inside the body in a single session. These tiny radioactive seeds give off a high radiation dose to the tumor while reducing the radiation exposure to nearby healthy tissues.
  • Stereotactic body radiation therapy (SBRT), including:
    • CyberKnife®: This painless, non-invasive type of stereotactic radiosurgery allows us to precisely target the affected area for maximum success in 5 treatments versus 40 treatments needed in conventional radiation. We were the first on the east coast to offer CyberKnife technology and have performed over 2,000 procedures with this technology, making us one of the most experienced in the region.
  • External beam radiation therapy (EBRT): EBRT targets the prostate from outside the body using image-guided, intensity-modulated radiation therapy or proton therapy. It requires daily sessions five days a week for five to eight weeks.
    • Proton therapy: We were the first facility in the world to offer proton therapy with HYPERSCAN technology, the latest and most precise form of proton therapy. Proton therapy uses energy from protons instead of photons, allowing high-dose radiation with no exit dose, resulting in fewer side effects than traditional radiation.

Radiopharmaceutical drugs

In addition, we offer several radiopharmaceutical drugs, which are medications that have particular radioactive substances designed to target cancer cells. Many of these are offered in clinical trials, allowing us to find new and better ways to treat patients before they are widely available. For example, we conducted clinical trials for the drug Xofigo, which is now an FDA-approved treatment that can extend survival and delay symptoms for men who have hormone-resistant metastatic prostate cancer. We continue investigating new ways to use radiopharmaceuticals, including drugs delivered to a prostate cancer protein called prostate-specific membrane antigen (PSMA). This can be an effective way to treat men with cancer that has spread to the bone.

Looking for expert cancer care?

With multiple locations throughout the region, patients have access to many of the nation’s renowned cancer specialists offering high quality care, second opinions and a chance for better outcomes close to where they live and work. Georgetown Lombardi Comprehensive Cancer Center, one of the nation’s comprehensive cancer centers designated by the National Cancer Institute (NCI), serves as the research engine allowing patients access to clinical trials that often lead to breakthroughs in cancer care.

Our locations

Distance from Change locationEnter your location

MedStar Franklin Square Cancer Center at Loch Raven Campus

5601 Loch Raven Blvd.
Ste. 103
Baltimore, MD 21239

MedStar Health: CyberKnife Center at MedStar Franklin Square Medical Center

9103 Franklin Square Dr.
Suite 100
Baltimore, MD 21237

MedStar Georgetown Cancer Institute at MedStar Franklin Square Medical Center

9103 Franklin Square Dr.
The Harry and Jeanette Weinberg Cancer Institute
Suite 220
Baltimore, MD 21237

MedStar Georgetown Cancer Institute at MedStar St. Mary’s Hospital

25500 Point Lookout Rd.
First Fl.
Leonardtown, MD 20650

Why choose us

Every prostate cancer case is unique, and we help you choose the best option. We offer patients a complete array of advanced therapies, including those that may be hard to find elsewhere. As a patient, you'll benefit from:

  • Some of the most experienced prostate experts working together to deliver exceptional care.

    Our surgeons and oncologists are international leaders in using the latest technology and therapies. While care from just one of them could lead to excellent outcomes, it's our collaborative approach that leads to stellar results for our patients. Research suggests that a multidisciplinary approach to cancer care improves outcomes, lowers costs, and enhances patients' overall well-being. Here, our experts meet regularly on tumor boards to design personalized treatment plans, involving input from:

    • Urologic oncologists
    • Radiation oncologists
    • Medical oncologists
    • Robotic surgeons
    • Radiologists
    • Urologists
    • Nurse practitioners
    • Physical therapists
    • Pathologists specializing in the urinary tract and reproductive system
    • Genetic counselors
    • And others
  • Advanced treatment that considers your quality of life.

    While stopping cancer is always our primary goal, we also strive to preserve your urinary and erectile function. We know you value your quality of life after treatment as much as your longevity. Therefore, we offer approaches like nerve-sparing surgery and highly-precise radiation therapies that result in fewer side effects than traditional treatment options.

  • Evidence-based clinical trials and research available throughout an expansive network.

    Our doctors and scientists are studying new, targeted therapies and novel combinations of chemotherapies, hormones, and drugs delivering radiation treatments. Clinical trials give many men access to the next generation of therapies months and even years before they become widely available—a benefit not available everywhere. Because we have ten hospitals and numerous outpatient clinics, we offer the best academic medicine at convenient hospitals and doctor's offices close to home throughout Washington, D.C., and Maryland.

Awards and recognition

Recipient of an Accreditation with Commendation, the highest level of approval, from the American College of Surgeons' Commission on Cancer (CoC)

Accreditation in radiology and imaging by the American College of Radiology (ACR)

Numerous surgeons, medical oncologists, radiation oncologists, and urologists recognized as "Top Doctors" by both Baltimore Magazine and the Washingtonian

Magnet® designation from the American Nurses Credentialing Center (ANCC)

Clinical trials and research

Clinical trials

We offer clinical trials that allow some men to receive novel therapies long before they're widely available. The goal of clinical trials is to improve the effectiveness of existing treatments by using them earlier or in combination with something else or to find new therapies for both early-stage and metastatic prostate cancers. We continue to study new ways to use radiation, chemotherapies, hormone therapies, and radiopharmaceuticals to help men live longer and with the best quality of life

Research

We partner with the Georgetown Lombardi Comprehensive Cancer Center, which allows us to investigate new ways to detect, prevent, and treat prostate cancer. Because we're actively involved in this research, we don't have to wait years for new findings to be published in medical books. Instead, we can offer men with prostate cancer the latest guidance and options in individualized medicine as soon as it becomes available.

Patient stories

Support services

Your treatment plan considers all aspects of your physical, emotional, spiritual, and financial needs. Here, you'll find comprehensive support services designed to help you and your family navigate your diagnosis. From patient-to-patient peer support or counseling to specialized care to address changes in your sexual function and reproductive health that arise throughout or after treatment, we're here for you whenever you need us.

Genetic counseling

Do you have a family history of prostate, breast, or ovarian cancer? If so, you may carry a higher risk of developing the disease. Our board-certified genetic counselors offer comprehensive services to help you understand your risk of developing prostate cancer based on your family history and genetic makeup. They'll help you understand the pros and cons of genetic testing, which may help family members manage their disease risk, too.

Through our collaboration with the Georgetown Lombardi Fisher Center for Hereditary Cancer and Clinical Genomics Research, we're investigating new and innovative ways to detect, treat, and manage hereditary cancers like prostate cancer. As a patient at MedStar Health, you may benefit from these research findings as soon as they're available.


Personalized rehabilitation

Prostate cancer treatment can affect your strength, endurance, and range of motion, making it hard to return to the hobbies and daily activities you enjoy. Our physical therapists and occupational therapists have specialized training in helping men improve their quality of life after treatment. You'll benefit from an individualized rehabilitation plan to help you move easier.


Survivorship

Our care for you doesn't stop when you become cancer-free. Through our survivorship program, we follow every patient as they cope with any physical and emotional changes after cancer treatment. From follow-up medical care and preventing recurrence to dealing with insurance issues, employment, or family transitions, your care team will develop a plan to help you thrive after treatment.