Once prostate cancer is found, tests are done to find out if the cancer has spread and, if so, to what extent. Treatment depends on how far the cancer has spread. You will work with a team of specialists to develop a treatment plan for you.
Treatment options include:
This involves your doctor monitoring the cancer to see if it is growing. Watchful waiting may be appropriate if you:
Have early stage prostate cancer that is growing slowly
Are of an advanced age
Have serious health problems (risks of treatment outweigh the benefits)
Types of surgery that may be needed include:
Pelvic lymphadenectomy—removal of lymph nodes in the pelvis to determine if they contain cancer
involves the use of radiation to kill cancer cells and shrink tumors. Examples include:
Conformal radiation therapy—conformal radiation therapy uses three-dimensional radiation beams that are conformed into the shape of the diseased prostate. This treatment spares nearby tissue the damaging effects of radiation.
Intensity-modulated radiation therapy (IMRT)—IMRT
uses radiation beams of different intensities to deliver higher doses of radiation therapy to the tumor and lower doses to nearby tissues at the same time.
If prostate cancer has spread or has returned after being treated, hormone therapy may be used. The goal of hormone therapy is to lower the levels of male hormones, called androgens. The main androgen is testosterone. Lowering androgen levels can cause prostate cancer to shrink or slow its growth. Examples of hormone therapy include:
Luteinizing hormone-releasing hormone (LHRH) analogs (such as goserelin, histrelin, leuprolide, triptorelin)—these drugs cause testosterone to drop to a very low level.
Luteinizing hormone-releasing hormone (LHRH) antagonists (such as degarelix)—these also reduce the testosterone level, but do so faster and without the surge of testosterone that happens with the LHRH analogs.
Anti-androgens (such as bicalutamide, flutamide, nilutamide)—these drugs work by interfering with the body's ability to use androgens.
Other types of hormone therapy, such as:
Estrogen therapy—rarely used now unless other treatments are not working
Ketoconazole—affects the production of androgens
Abiraterone—may be used in cases where prostate cancer does not respond to other treatments
Orteronel (experimental drug)—affects the production of androgens
Enzalutamide—affects the production of androgens
Abiraterone—may be used in advanced stages of prostate cancer
In some case, a type of surgery called orchiectomy may be needed. This involves removing the testicles, which stops androgens from being produced.
Other Treatment Options
Other options may include:
Cryosurgery—this involves using an instrument to freeze and destroy prostate cancer cells
Chemotherapy—if prostate cancer has spread and other treatments have not been effective, chemotherapy may be used. There are range of chemotherapy drugs available, such as:
Docetaxel (this is usually the first chemotherapy drug that is tried)
Immunotherapy—Immunotherapy is a drug treatment that aims to build your immune system so that you can better fight cancer cells. Sipuleucel-T is a type of immunotherapy that is approved to treat prostate cancer that has spread.
Targeted therapies—Targeted therapies focus on the cancer cells, rather than attacking both the cancer cells and the healthy cells. Some examples include:
Selective endothelin A receptor antagonist (SERA)—interferes with the process that cancer cells go through to grow
Anti-angiogenic drugs—blocks the formation of new blood vessels, which stops the growth of the cancer cells
Tyrosine kinase inhibitors (such as Imatinib)—blocks the protein that triggers the cancer cells to multiply
High-intensity focused ultrasound—This treatment involves using an endorectal probe (a probe that is inserted into the rectum) to destroy cancer cells with ultrasound energy.
Angiogenesis inhibitors. National Cancer Institute website. Available at: http://www.cancer..... Accessed September 19, 2012.
Biological therapies for cancer. National Cancer Institute website. Available at: http://www.cancer.gov/cancertopics/factsheet/Therapy/biological. Accessed September 19, 2012.
Chemotherapy for prostate cancer. American Cancer Society website. Available at: http://www.cancer..... Updated February 27, 2012. Accessed September 19, 2012.
Evolution of cancer treatments: targeted therapy. American Cancer Society website. Available at: http://www.cancer..... Updated June 8, 2012. Accessed September 19, 2012.
FDA approval for sipuleucel-T. National Cancer Institute website. Available at: http://www.cancer.gov/cancertopics/druginfo/fda-sipuleucel-T. Accessed July 31, 2012.
Hormone (androgen deprivation) therapy for prostate cancer. American Cancer Society website. Available at: http://www.cancer..... Updated September 4, 1012. Accessed September 19, 2012.
Hormone therapy for prostate cancer. Mayo Clinic website. Available at: http://www.mayocli.... Updated August 10, 2012. Accessed September 19, 2012.
Imatinib. PubMed Health website. Available at: ...(Click grey area to select URL) Accessed July 31, 2012. Accessed September 19, 2012.
Prostate cancer. EBSCO DynaMed website. Available at:
https://dynamed.ebscohost.com/about/about-us. Updated August 20, 2012. Accessed September 19, 2012.
Screening for prostate cancer: current recommendation. US Preventative Services Task Force website. Available at: http://www.uspreve.... Published May 2012. Accessed July 31, 2012.
Targeted therapy for prostate cancer. Texas Oncology website. Available at: http://www.texason.... Accessed July 31, 2012.
What is biological therapy? National Cancer Institute website. Available at: http://www.cancer.gov/cancertopics/treatment/biologicaltherapy. Accessed September 19, 2012.
What’s new in prostate cancer research and treatment? American Cancer Society website. Available at: http://www.cancer..... Updated September 4, 1012. Accessed September 19, 2012.
What is provenge? Provenge website. Available at: http://www.provenge.com/advanced-prostate-cancer-therapy.aspx. Accessed July 31, 2012.
Xtandi (Enzalutamide) approved for late stage prostate cancer, FDA. Medical News Today website. Available at: http://www.medicalnewstoday.com/articles/249785.php. Accessed September 19, 2012.
2/12/2010 DynaMed's Systematic Literature Surveillance
https://dynamed.ebscohost.com/about/about-us: Smith DP, King MT, Egger S, et al. Quality of life three years after diagnosis of localised prostate cancer: population based cohort study.
2/19/2010 DynaMed's Systematic Literature Surveillance
: Mahmud SM, Franco EL, Aprikian AG. Use of non-steroidal anti-inflammatory drugs (NSAIDs) and prostate cancer risk: A meta-analysis.
Int J Cancer.
2010 Jan 20.