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Prostate Cancer Treatment

Prostate cancer treatment isn't one-size-fits-all. Often, you have choices about next steps. You might have the choice to wait the cancer out. Or, you might get to choose between radiation and surgery. How do you know the best route to take? 

To make choices about your treatment, you'll need information and answers you trust. At UVA Health, we have all the resources you need to feel confident in your decisions and care. Our experienced experts offer skilled support in helping you map out what's next. And we have the latest high-tech tools that give you options.

Whatever your situation, you can trust that our specialists will optimize your treatment to meet your needs.

Spotlight on Prostate Cancer Treatment

Kirsten Greene, MD, explains what to expect when you come to UVA Health for prostate cancer treatment.

Prostate Cancer Treatment at UVA Health

Top-Rated Prostate Surgical Care

Prostate cancer is often a slow-growing cancer. In this case, you have a choice to act or to wait.

What is Active Surveillance?

You may choose to closely follow the cancer with your doctor. This is called active surveillance: It's an option if you:

  • Have early stage, low-grade prostate cancer that is growing slowly
  • Want to prioritize your quality of life over treatment for a while

Active surveillance requires:

  • PSA blood tests at least twice a year
  • Usually an MRI scan of your prostate
  • Repeat prostate biopsies to check on the cancer

The goal of active surveillance is to watch the cancer as long as it is safe. We can still cure it when the time comes for treatment.

Watchful Waiting vs. Active Surveillance

Sometimes your doctor will recommend another option: Watchful Waiting. This means you never want or need to have curative treatment. Watchful Waiting and Active Surveillance are very different. You want to be sure you know which one is right for you.

Recently Diagnosed With Prostate Cancer?

Powerful Prostate Cancer Treatment

If you need treatment for aggressive prostate cancer, you'll find the very latest tools and methods at UVA Health. We can customize your care based on whether your cancer is only in the prostate (localized) or has spread to other parts of the body.

Depending on the stage of your cancer, treatment might include:

  • Prostatectomy — surgery to remove the prostate, seminal vesicles, and sometimes lymph nodes 
  • Brachytherapy — kills the cancer in the prostate using targeted seeds
  • MR-Linac — precise external beam radiation
  • Hormone therapy — blocks the hormones that cause cells, including cancer cells, to grow
  • Vaccine therapy — boosts your immune system
  • Targeted therapy
  • Chemotherapy
  • Radiation isotope therapy (Pluvicto) — treats prostate cancer has spread to other parts of the body
  • Radiation — to relieve pain from disease that's spread to bone

Treatment Spotlight: da Vinci® Robotic Surgery

Our experts have years of experience performing robotic surgery. We're the first in Virginia to offer the da Vinci 5 (DV5) robotic surgical system for prostatectomy. The DV5 represents a major advance in a 30-year evolution of robotically-assisted surgery.

This procedure uses a miniature camera and robotic “hands.” Your doctor inserts them into the body through a series of tiny incisions. These tools ensure steadiness and precision. This form of surgery benefits you because it:

  • Reduces blood loss
  • Increases healing
  • Offers good results for urinary control 
  • Aids sexual function recovery

Why Screening Matters

After skin cancer, prostate cancer is the most common cancer in American men. Talk to your doctor about getting a blood test called PSA every year. This test, plus a rectal exam, can catch cancer early. But you'll need a biopsy to confirm if it's cancer.

Not everyone wants to be checked for prostate cancer. So your doctor will talk with you about your own goals and preferences.

Prostate Cancer Clinical Trials
Research study for adults at risk, diagnosed with, or being evaluated for cancer

The University of Virginia Cancer Center needs your help to find new ways to diagnose, treat and prevent cancer. As a member of ORIEN, the Oncology Research Information Exchange Network, we are part of a network of cancer centers throughout the United States working collaboratively to quickly carry out research on all types of cancer. No two cancers are exactly the same. Currently we treat most cancer patients with standard treatment, however patients that have the same kind of cancer do not always respond to the same type of treatment. The purpose of this study is to help us better understand differences between cancer patients and to find ways to prevent, diagnose and treat cancer patients more on an individual level. If you are eligible for the study and consent to participate, the study involves a donation of leftover tissue that would normally be discarded, collection of blood during a routine blood draw and giving permission for review of your medical information. All of the medical information and samples collected will be coded to protect your privacy There is no cost to be involved in this study. Ages: 18 years of age and older

Research study for adults with Prostate cancer

COMPPARE stands for “A Prospective COMparative Study of Outcomes with Proton and Photon RAdiation in PRostate CancEr (COMPPARE).” This study, which is funded by the Patient-Centered Outcomes Research Institute (PCORI) and approved by the University of Florida Institutional Review Board, will compare the quality of life, side effects, and cure rates for prostate cancer patients treated with proton therapy or photon therapy. We will ask 3000 men between the ages of 30-85 across the US who will be treated with either protons or photons to participate in COMPPARE. Proton therapy patients can choose to participate in a randomized trial that will evaluate whether quality of life, side effects, and prostate cancer cure rates differ between patients receiving the standard therapy versus a shorter therapy. For this study, UVA is participating as a photon therapy treatment site only Participants will answer brief surveys regarding treatment choice, quality of life, and side effects for at least 3 years. Clinic follow ups will occur 3 months, 6 months, 12 months, 18months, and then annually after treatment completion.

Phase 1/2a, Open-label, Multicenter Study of Intramuscular PRL-02 Depot in Patients with Advanced Prostate Cancer

The University of Virginia is conducting a clinical research study for adults ages 18 and over, who have advanced prostate cancer. If you join this study, you will receive an investigational drug, PRL-02. The main purpose of this study is to test PRL-02 to find out which is the best dose to use in future research studies. The study also aims to assess the safety of PRL-02, how it is absorbed by and cleared from the body, and how well it works against prostate cancer. Everyone who takes part will be treated with PRL-02 in combination with prednisone or dexamethasone. Recruitment and treatment with the study medication is expected to last up to approximately three years. After that, there is a follow-up period of one month. This means you could keep seeing the Study Doctor for approximately three years, if you participate on this study. Study-related procedures that are being done beyond your standard of care will be provided at no cost to you or your insurance. Additional information can be found here: https://clinicaltrials.gov/ct2/show/NCT04729114 [email protected]

) A Phase 1/2 Open-Label, Dose-Escalation and Cohort Expansion Clinical Trial to Evaluate the Safety, Tolerability, Pharmacokinetics, and Pharmacodynamics of ARV-766 in Patients with Metastatic Castration-Resistant Prostate Cancer

The University of Virginia is participating in a clinical research study for adults ages 18 and over, who have Metastatic Castration-Resistant Prostate Cancer (mCRPC). The purpose of this study is to assess the safety and tolerability (good and bad effects) and how prostate cancer responds to two different doses of the investigational study drug (ARV-766) in men with metastatic cancer of the prostate who have progressed on prior approved systemic therapies for disease like yours (one of which must be enzalutamide, darolutamide, apalutamide or abiraterone). "Investigational" means the drug being tested has not been approved by any regulatory authority, for example, the United States Food and Drug Administration (FDA). The study also seeks to evaluate how the drug moves within the body after administration and what effects the drug has on your body after administration. You will be in the study as long as there is evidence that the treatment is helpful for your prostate cancer and you are tolerating treatment well, which has the potential to be up to 1-2 years. However, the total length of treatment is unknown as you will continue to receive treatment in this study until your disease worsens, or you experience toxicity (side effects that are severe), you withdraw your consent from the study, or it is decided by the study doctor or sponsor to stop your participation. All drugs will be delivered via an oral tablet. Study-related procedures that are being done beyond your standard of care will be provided at no cost to you or your insurance. Additional information can be found here: https://clinicaltrials.gov/ct2/show/NCT05067140 [email protected]

A phase 1/2 study of Anti-PSMAXCD28 with or without Anti-PD-1 in patients with metastatic castration-resistant prostate cancer and other tumors associated with PSMA expression

The University of Virginia Comprehensive Cancer Center seeks adults ages 18 and over with metastatic prostate cancer or metastatic renal cell carcinoma to participate in a research study. This study will evaluate the effectiveness of Anti-PSMAXCD28. Anti-PSMAXCD28 is investigational, which means it has not been approved by the U.S. Food and Drug Administration (FDA) or any other health authority for marketing for any condition. Some participants may also receive an additional study drug (Anti-PD-1) in combination with Anti-PSMAXCD28 if their cancer worsens. Anti-PD-1 is approved in multiple countries to treat adult patients with different cancer types, however it has not been approved by any health agency to treat prostate or renal cancer and it has not been approved for use in combination with Anti-PSMAXCD28. Anti-PSMAXCD28 (with or without Anti-PD-1) is being studied for the treatment of previously treated prostate cancer or metastatic renal cell carcinoma. This study is being done to learn about the safety of Anti-PSMAXCD28 and find out what dose of Anti-PSMAXCD28 can be given in patients with prostate cancer and metastatic renal cell carcinoma. An additional purpose of the study is to look for signs that Anti-PSMAXCD28 can help your immune system reduce or destroy your tumor. The study involves receiving the investigational study drugs, as well as coming in for study visits, which include exams, laboratory tests, and procedures such as having your blood drawn, and talking to the study doctor. If you are eligible for the study and consent to participate, your involvement includes a screening period of up to 28 days, a treatment period of a series of 6-week cycles, two follow-up visits after treatment, and a follow-up period via phone calls to keep track of how you are doing. Some participants may have follow-up imaging scans – these would be at a similar interval to routine scans. How long you will be on the study depends on your ability to safely tolerate the study drugs, your response to the study drugs, and your and/or your study doctor’s decision for you to continue in the study. Anti-PSMAXCD28 and Anti-PD-1 will be provided by the sponsor at no cost to you. All additional study procedures, including laboratory tests, physical examinations, and visits to the study center are provided to you at no charge. Additional information can be found here: https://www.clinicaltrials.gov/study/NCT03972657 [email protected]

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