Full speed ahead for prostate cancer detection and treatment

In this article: 

• Major advances in the detection and treatment of prostate cancer include more tailored, targeted therapies and a significantly improved experience for patients. 
• Swedish is home to the country's premier experts in stereotactic radiosurgery. The technique delivers a precise dose of radiation that does not affect healthy tissue. 
• Providence Swedish is participating in research around new therapies which will be tomorrow's state-of-the-art treatments for patients with prostate cancer. 

When it comes to a prostate cancer diagnosis, early detection and treatment are critical for the best outcomes. The stats for this disease are overwhelming: Prostate cancer is the second-most common cancer among men in the U.S., affecting 13 out of every 100 American men in their lifetime. For two to three of those men, the disease will be fatal. As grim as those numbers sound, there is good news.

“We’re able to detect the spread of prostate cancer better than ever before,” says radiation oncologist Vivek Mehta, M.D., director of the Providence Swedish Center for Advanced Targeted Radiotherapies at Swedish Cancer Institute.

Along with better detection, treatments are also more precise and effective than they were just a few years ago. Ten years ago, a prostate cancer patient would have to undergo a challenging surgery to remove the prostate, followed by a series of radiation treatments using an external machine directed at cancer cells. In recent years however, new approaches and technology have made surgery and treatment more personalized, precise, and targeted.

Exciting new approaches are here, and there are more on the way, Dr. Mehta says.

Treatment pathways

Along with surgery and radiation, a prostate cancer patient may be put on a treatment path that includes medication-based treatment, clinical trials, ultrasound, and even freezing cancer cells. Using new technology, radiation tools can target exactly where cancer cells are and spare excess damage to surrounding tissue. “The oncologist’s radiation tools for delivering radiation are evolving by leaps and bounds every five years,” says Dr. Mehta.

One radiation tool, stereotactic radiosurgery or the CyberKnife device, delivers high-dose radiation with imaging, precisely concentrating radiation on a moving target without affecting healthy tissues.

“CyberKnife is what Providence Swedish is known for,” Dr. Mehta says. “Patients seek us out, and we treat more people with that technology than any other health care system in the Northwest.”

New robotic surgery devices allow patients to recover faster, some even going home the same day of surgery. “The past 20 years have changed the patient experience,” says James Porter, M.D., medical director for robotic surgery at Swedish Urology First Hill and director of robotics for Providence Health and Services.

Dr. Porter has completed more than 5,000 da Vinci robotic system procedures, making him the most experienced surgeon with this system in the Pacific Northwest, and one of the top five practitioners in the nation. Over the years, the da Vinci robot has been finetuned to improve accuracy, control, imaging, and reduce the size of both the robotic hand and its surgical incisions.

Advances in surgical techniques and precision treatment are not only improving patient experience, but outcomes and side effects as well. “Ten years ago, radiation treatment for prostate cancer might take place Monday through Friday over seven weeks, around 35 visits. We can do the same treatment in just five, 40-minute visits today,” Dr. Mehta says. With fewer, more targeted treatment sessions, patients may experience less nausea, diarrhea, bleeding, and bladder complications.

On the horizon

It’s likely that the next significant jump in treatment options will be radiopharmaceuticals, or medications that target and treat more resistant prostate cancers. New medications are in trials at Providence Swedish, among other hospitals and research centers.

Swedish’s involvement in clinical trials only improves the options for prostate cancer patients. “You can get state-of-the-art treatment now or participate in trials that define the state of the art for tomorrow,” Dr. Mehta says.

The best treatment path still starts with early detection. “New prostate cancer treatments are only helpful if patients are diagnosed early,” Dr. Porter says. For those already showing symptoms, their stage of cancer is more likely advanced. Later stages are harder to treat and have lower chances of curing the cancer. “For those late in the disease [trajectory], we have less to offer.”

Men between the ages of 55 and 69 can use a simple blood test to measure levels of a specific substance made by the prostate. Higher levels indicate a potential problem and can help with early diagnosis and treatment.

Dr. Porter advocates for men to get the test done with their primary care provider.

“We need to diagnose prostate cancer and get to it before it becomes life threatening.” he says.