Active Surveillance

Sometimes, the best course of action with prostate cancer is “active surveillance,” also known as “watchful waiting.” That’s because prostate cancer is usually slow growing. If the cancer is low risk and not likely to spread, our physicians may recommend delaying treatment. Active surveillance is not right for everyone and we have established protocols to determine when it should be used. At Marin General Hospital, active surveillance is not a passive process; it’s a structured program run out of our Center for Integrative Health & Wellness that focuses on nutrition, exercise and other lifestyle changes, as well as physician follow-up.

If there are no worrisome changes, active surveillance can continue indefinitely, with a check-in every six months. More than 50% of our patients on active surveillance continue to remain on active surveillance 5 years later without additional need for treatment.

Radiation Therapy

Radiation Oncology uses radiation to kill cancer cells and shrink tumors. One option is external beam radiation therapy in which the tumor is targeted with high-energy beams. Another delivery method commonly used with prostate cancer is internal radiation therapy, or brachytherapy, in which “seeds” of radioactive material are placed inside the body, in and around the tumor.

Hormone Therapy

The male hormone testosterone fuels the growth of prostate cancer cells. By cutting off the body’s supply of testosterone, hormone therapy kills cancer cells or slows their growth. Hormone therapy for prostate cancer may include medications and can involve surgery to remove the testicles in advanced cases. Hormone therapy is generally only used for advanced or recurrent prostate cancer.


Chemotherapy is the use of medications that interfere with the growth and replication of cancer cells. It is typically administered intravenously or orally. Chemotherapy has evolved since it was first introduced, and we can now better control nausea and other side effects.

Robotic Prostatectomy

Surgical removal of the prostate may be an option for patients who are healthy enough to have an operation. We offer the most cutting-edge techniques for robotic prostate surgery, including athermal nerve-sparing, bladder neck preservation, and extended pelvic lymph node dissections. Our goal is to remove all the cancer with as little impact to quality of life as possible. With our advanced robotic technology, our surgeons can achieve excellent cancer control outcomes, while offering some of the best results for continence and potency. Robotic-assisted surgery is minimally invasive and typically results in less blood loss, less scarring and faster recovery. Most patients are discharged the day after surgery with very little pain.