Treating Your Cancer : Browse by Cancer Type

Prostate Cancer

For those who are diagnosed with prostate or bladder cancer, choosing the appropriate treatment can be challenging.

For low-risk prostate cancers for which there is a high probability that the disease is contained within the prostate, there are multiple treatment options. Patients may be considered for external beam radiation, prostate brachytherapy, radical prostatectomy or active surveillance. Each patient must discuss options with his physician to determine the best course of treatment for his individual case.

At Sylvester Comprehensive Cancer Center, external beam radiation therapy for prostate cancer is delivered utilizing the latest intensity modulated radiation, known as intensity-modulated arc therapy (RapidArc® IMAT). This technology enables us to provide highly conformal radiation treatment with a shorter daily treatment time than is possible with typical intensity-modulated radiation therapy (IMRT) techniques. We also use dynamic contrast enhancement to help identify any areas within the prostate that may be affected by the cancer. Daily imaging (image-guided radiation therapy—IGRT) helps ensure precise delivery of radiation treatment. Cone beam CT scan can be used in addition to x-rays to better position patients during treatment. We use fiducial seeds placed in the prostate to track the precise location of the prostate, and the Calypso® real-time tracking system – “GPS for the body” – enables our doctors to track prostate motion during radiation therapy. Noninvasive methods of tracking the prostate during radiation delivery include the Clarity® 3D ultrasound system.

Prostate brachytherapy involves the placing of small radioactive seeds into the prostate to treat the prostate with radiation from the inside out. This allows very high doses of radiation to be delivered safely to the prostate while minimizing harm to the surrounding organs. This procedure is done in the operating room, often under general anesthesia. We also use dynamic contrast enhancement to help identify any areas within the prostate that are potentially affected by the cancer. This information is all incorporated into the Spot Pro® treatment planning system, which allows us to plan in real time in the operating room and update our treatment plan based upon the actual location of the seeds in the prostate. We also use the First® system, which is a unique system that enables robotic brachytherapy, and greatly increases the flexibility and the accuracy of seed delivery.

Patients with higher risk cancers may have their external beam therapy combined with androgen deprivation (hormones). External beam radiation also may be combined with brachytherapy.

For patients with bladder cancer, the combination of chemotherapy and radiation can offer an alternative to surgical removal of the bladder. Our ability to use RapidArc® and IGRT enables us to deliver higher doses of radiation to the tumor while minimizing the dose to the surrounding normal bladder tissues. The goals of this treatment are fewer side effects, a more functional bladder, and higher cure rates.

Ongoing research at the University of Miami Miller School of Medicine is looking for ways to better identify the tumors within the prostate utilizing our 3T MRI and dynamic contrast enhancement. With advances in technology, we are able to target these areas with higher doses of radiation using both external beam radiation and brachytherapy.

The genitourinary team is led by Alan Pollack, M.D., Ph.D, Chairman, Department of Radiation Oncology, and Matthew C. Abramowitz, M.D.

To learn more about Prostate Cancer, please visit the Prostate Health Library.