Prostate Cancer

When it comes to prostate cancer, there are no easy answers. We strive make it easier. We confirm a prostate diagnosis, even when prostate cancer is hard to find because the tumors are very small. We are experts at diagnosing these challenging cases.

Our specialized team develops a personalized treatment plan for you that aims to preserve your urinary and sexual function. We explore all minimally invasive options, including active monitoring before recommending surgical removal of your prostate or external radiation therapy. We offer minimally invasive treatments such as cryosurgery -- a type of focal therapy that targets a section of the prostate gland containing the cancer rather than the whole prostate -- and high-dose brachytherapy radiation, which kills cancer cells in your prostate while potentially preserving healthy tissue.

We are also strong advocates of active surveillance or “watchful waiting” for small, nonaggressive prostate cancer. We believe active surveillance is a safe and important course for certain men with prostate cancer who may be candidates to avoid treatment altogether.

Active Surveillance

Our active surveillance program combines sophisticated prostate MRI imaging with your tumor genetics to provide a personalized risk assessment. Your doctor monitors your prostate cancer with periodic diagnostic tests, which provides a level of confidence that your cancer can continue to be safely observed. We recommend "watchful waiting" for very small and slow-growing cancers that do not cause any symptoms.


Surgery

Most prostate cancer surgeries remove the entire prostate and some surrounding tissue in a procedure called a prostatectomy. We perform this surgery two ways:

• Radical retropubic prostatectomy is performed through a single, small abdominal incision. This conventional technique leads to smaller scars, less pain, and a faster recovery.
• Robotic prostate surgery removes the prostate and tissue with the assistance of tiny, robotic instruments that allow your surgeon to operate with extreme precision.

Transurethral Resection of the Prostate

Relieves symptoms caused by an enlarged prostate by removing any prostate tissue blocking urine flow.

Cryosurgery

Freezes and kills prostate tissue by inserting cooled argon into the prostate with a needle. Using ultrasound pictures as a guide, your doctor can freeze and treat your entire prostate without the need for surgery. Cryosurgery is a minimally invasive, needle-based outpatient procedure.

Radiation Therapy

An alternative primary treatment for small, early-stage prostate cancer in men who want to avoid surgery. In advanced cases, radiation reduces tumor size or relieves symptoms. Highly focused radiation therapy uses advanced imaging technology that focuses radiation beams directly onto your tumor and takes into account its size and shape. We use 3-D conformal radiation therapy and intensity modulated radiation therapy (IMRT). 

High-Dose Brachytherapy

Delivers very high doses of radiation from temporary implants placed inside your body near your prostate tumor.

Chemotherapy

Kills or slows the growth of cancer cells in cancers too advanced for treatment with surgery or radiation therapy alone. Chemotherapy may also be used to help relieve symptoms.

Hormone Therapy

Medication or surgical removal of the testicles (orchiectomy) reduces how much testosterone your body produces. This male hormone helps prostate cancers grow. Hormone therapy may help shrink tumors or slow the growth of cancer cells left behind after surgery or radiation therapy.

Prostate-Specific Antigen (PSA)

Blood test that measures levels of PSA produced by your prostate. High levels may indicate cancer.

Digital Rectal Exam

Your doctor inserts a surgically gloved finger into your rectum to examine your prostate.

Biopsy

A needle inserted into your prostate collects a tissue sample that can be analyzed for the presence of cancer.

Multi-Parametric MRI

Specialized prostate MRI exam that can determine the size, number, location, and aggressiveness of tumors within the prostate.

National Reputation
Our prostate cancer program combines two top-ranked programs. We are one of the select centers designated by the National Cancer Institute as a Comprehensive Cancer Center, and we part of the National Comprehensive Cancer Network, an alliance of the nation’s leading cancer centers dedicated to improving care for our patients.

Diagnostic Center of Excellence
We are a high-volume referral center because of our expertise in diagnosing hard-to-find or difficult cases of prostate cancer. If you have cancer, our team will find it and develop a personalized treatment plan for you.

Excellent Results from Experience
We regularly see a wide variety of men with prostate cancer, from small tumors to the most complex cases. Our experience with so many types of tumors, combined with our high patient volume, helps us achieve outstanding outcomes.

Surgical Expertise
We offer the full range of minimally invasive surgical options, from cryosurgery and laparoscopy to robot-assisted procedures. Today, robotic prostate surgery is the gold standard for prostate cancer surgery. Duke was one of the earliest adopters of robotic surgery in North Carolina, and all of our robotic surgeons are fellowship-trained, meaning they studied additional years to become experts in urologic surgery.

Leaders in Focal Therapy
We are studying all aspects of focal therapy, which is the male version of a "lumpectomy." It targets a section of the prostate gland and kills the cancer while leaving the healthy tissue in place. Our work in the field of focal therapy, including access to clinical trials and cryosurgery, is making focal therapy options available to more people and achieving better results.

Expertise in Systemic Therapy
We are one of 13 Department of Defense Prostate Cancer Clinical Trial Consortium sites where new drugs are being developed and delivered to men with advanced prostate cancer, thus providing access to potentially game-changing therapies. Duke investigators have been closely involved in the development and approval of therapies now available to men with advanced prostate cancer, including newer hormonal therapies, immunotherapies, chemotherapies, and radiopharmaceuticals.

Team of Specialists
Our prostate cancer team includes surgeons, radiation oncologists, and medical oncologists who specialize in prostate and urologic cancers. The support team also includes a Prostate Cancer Survivors clinic and pelvic floor physical therapy to rehabilitate urinary function.

Clinical Trial Access
You may be eligible to participate in our ongoing prostate cancer clinical trials, which give you access to new anti-cancer targeted therapies, new surgical approaches, and ways to minimize common cancer-related symptoms before these treatments become widely available.

We Support You
Our comprehensive cancer support services help you with concerns ranging from how to minimize the side effects of treatment to coping with the emotional and psychological effects of your diagnosis and treatment. Learn more about our prostate cancer support groups.