Prostate Cancer Treatment Options in San Antonio

Every man’s experience with prostate cancer is different, which is why treatment plans need to be individualized.

Some men benefit from careful monitoring, while others need surgery, radiation, or advanced therapies. The approach you and your doctor choose depends on your age, cancer grade and stage, general health, and preferences.

At Urology San Antonio, we offer a comprehensive range of prostate cancer treatment options in San Antonio.

Active surveillance

Not every prostate cancer requires immediate treatment. For cancers that are small, slow-growing, or found in older men with other health concerns, active surveillance is often the best choice. This strategy involves regular office visits, PSA blood tests, and imaging. It allows your urologist to carefully monitor the cancer. If signs of progression appear, treatment can begin right away.

Radiation therapy

Radiation is a proven treatment for prostate cancer. Urology San Antonio, in partnership with the San Antonio Cancer Center, offers several different techniques:

• Brachytherapy: Tiny radioactive pellets are placed directly into the prostate during a short outpatient procedure. These “seeds” release radiation over time to target the cancer from within.
• External Beam Radiation Therapy (EBRT): Radiation is delivered precisely to the prostate while you lie comfortably on a treatment table. EBRT can also be used after surgery to destroy any remaining cancer cells.
• Stereotactic Body Radiation Therapy (SBRT): Another type of EBRT, SBRT, is a method that delivers high-dose, intense radiation. It offers effective treatment with fewer visits.
• Intensity-Modulated Radiation Therapy (IMRT): This approach utilizes multiple lower-intensity beams over approximately 45 short sessions. IMRT is designed to protect surrounding healthy tissues while treating the prostate.
• Pluvicto radioligand therapy: For men with new or recurrent PSMA-positive metastatic castration-resistant prostate cancer, Pluvicto offers a new targeted treatment option. Given through an IV, it delivers radiation directly to prostate cancer cells throughout the body.

Robotic Prostatectomy

Surgical removal of the prostate, called radical prostatectomy, is often recommended when the cancer is confined to the gland. Our surgeons perform robotic prostatectomy through small incisions in the abdomen. Robotic instruments provide a magnified, three-dimensional view of the surgical field. This allows for precise movements that may improve cancer control, help preserve nerve function, and promote faster recovery.

Hormone Therapy

Prostate cancer depends on testosterone to grow. Hormone therapy, also known as androgen deprivation therapy, reduces testosterone levels or blocks its effects. This treatment can shrink tumors or slow their growth and is sometimes combined with radiation. Hormone control can be achieved either with oral or injectable medications, often called medical castration. It can also be done with surgery to remove the testicles, a procedure known as orchiectomy or surgical castration.

Secondary Hormone Therapy

When the cancer no longer responds to initial hormone therapy, newer medications can be used:

• Zytiga (abiraterone): Blocks testosterone production in the testes, adrenal glands, and even within tumor cells.
• Xtandi (enzalutamide): Prevents testosterone from binding to prostate cancer cells, stopping the signal that drives their growth.

Cryotherapy

Cryotherapy destroys prostate cancer cells by freezing them. Thin probes deliver very cold gas into the prostate, while a warming catheter protects the urethra. Although not usually the first treatment offered, cryotherapy can be helpful if other options have not been fully successful.

Immunotherapy (Provenge / sipuleucel-T)

This therapeutic cancer vaccine trains your own immune system to recognize and attack prostate cancer. Your immune cells are collected, stimulated to target cancer, and then returned to your body through an infusion.

Bone-Directed Therapies

Prostate cancer often spreads to the bones, where it can cause pain and fractures. Treatments to protect bone health include:

• Xgeva® (denosumab): A monthly injection that strengthens bones and lowers fracture risk.
• Xofigo® (radium-223): A radioactive medicine that targets bone metastases, relieving pain and slowing disease progression.

If you’ve been diagnosed with prostate cancer, schedule a consultation with Urology San Antonio. Our specialists will help you understand your treatment options and guide you toward the plan that’s right for you.

Partner with our experts to explore your prostate cancer treatment options in San Antonio. We also offer prostate cancer second opinions to ensure you’re getting the best care possible.

1. Do all men with prostate cancer need immediate treatment?

No. Many prostate cancers grow slowly and may not cause problems for years. Active surveillance allows safe monitoring with regular check-ups and tests. Treatment can be started if the cancer begins to change.

2. What are the common side effects of radiation?

Some men experience urinary frequency, mild bowel changes, or fatigue during treatment. Modern approaches such as SBRT and IMRT are designed to minimize side effects by targeting the prostate with great precision.

3. Will surgery affect my sexual function?

Because the nerves controlling erections run alongside the prostate, surgery can sometimes affect sexual function. Whenever possible, surgeons perform nerve-sparing procedures to reduce this risk. Recovery may take time, and outcomes vary from person to person.

4. Are clinical trials available at Urology San Antonio?

Yes. Urology San Antonio participates in clinical trials through USA Clinical Trials. This gives patients access to promising new therapies that are being studied for safety and effectiveness.