A New Look at Prostate Cancer Treatment: Whole Gland vs. Targeted Therapy

Prostate cancer can be tricky—it often shows up in more than one area of the prostate, which makes choosing the right treatment complicated.

At a major prostate cancer conference in February 2025, Dr. Peter J. Rossi, a radiation oncologist from Valley View’s Calaway–Young Cancer Center (CYCC), shared his insights on the latest treatment options. He compared two main types: whole gland therapy, which treats the entire prostate and focal therapy, which targets only the tumor. He also discussed focal brachytherapy, a highly precise form of internal radiation.

Whole Gland vs. Focal Treatment

Treating the whole prostate has a strong track record and generally causes fewer serious side effects. Dr. Rossi is known for his success with Low Dose Rate (LDR) brachytherapy, a method where tiny radioactive seeds are placed directly inside the prostate. These seeds give off radiation over time, killing cancer cells while sparing nearby healthy tissue. The procedure is image-guided, takes less than an hour and is usually done on an outpatient basis. It’s a common choice for early-stage prostate cancer and can be combined with other therapies for more aggressive cases.

Focal therapy, on the other hand, only treats the cancer spot. While appealing for preserving urinary and sexual function, it’s still considered experimental due to limited data and unclear success criteria. Dr. Rossi noted that improved imaging and personalized care are making focal options more viable, but careful patient selection is key.

“It’s about finding the right treatment for the right patient—without overtreating or undertreating,” said Dr. Rossi.

Why Brachytherapy—and Local Access—Matters

Brachytherapy is a form of internal radiation that delivers high doses of treatment directly to the tumor, limiting damage to surrounding tissue. It’s efficient, effective and offers faster recovery compared to many other treatments.

Calaway–Young Cancer Center is one of only three centers in Colorado—and the only one on the Western Slope—accredited to perform brachytherapy. This makes CYCC a regional leader in advanced prostate cancer care, offering access to cutting-edge treatment without requiring patients to travel to Denver or Utah. For many, it means getting world-class care close to home.

“It is important to offer prostate brachytherapy in addition to the other radiation modalities we use to treat prostate cancer. This provides the most comprehensive list of options to allow us to personalize the care we offer to every patient,” said Dr. Lauren Kropp, an additional radiation oncologist at Calaway-Young Cancer Center who performs this technique.

Dr. Rossi, Dr. Kropp and the Calaway-Young team use a range of precision tools to tailor each patient’s treatment, including:

• SBRT (Stereotactic Body Radiation Therapy): A few highly targeted radiation sessions. CYCC is one of just a few NCI accredited sites for this treatment.
• EBRT (External Beam Radiation Therapy): MRI-directed intensity modulated arc therapy with advanced image guidance.
• Brachytherapy: Precise radiation treatment using either radioactive seeds (LDR) or temporary catheters (HDR) delivered directly to the cancer.

Dr. Rossi also shared a powerful example of using MRI-guided focal brachytherapy to precisely treat cancer while protecting vital organs and preserving future treatment options if needed.

He closed by stressing the importance of ongoing research, more long-term data and personalized care plans that strike the right balance between effectiveness and quality of life.

For more information on the Calaway-Young Cancer Center at Valley View, visit https://www.vvh.org/calaway-young-cancer-center.