Advanced Prostate Cancer: The Basics and Treatment Options

Jay Motola, M.D. | June 29, 2015 Nov 12, 2016

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Patients with prostate cancer that is not localized to the prostate and has spread can not be cured of their disease. However many treatments are now available that help prolong overall survival in patients with metastatic disease. Here are the basics you need to know as well as treatment options.

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Hormonally sensitive prostate cancer

Responds to the elimination of the male hormone testosterone by various medications.
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Hormonally refractory prostate cancer

Does not respond to the elimination of the male hormone testosterone by various medications and other medications are now available.
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Treatment outlook for hormonally sensitive prostate cancer

–Patients initially placed on medications known as LHRH agonists or antagonists, and possible antiandrogens
–For a period of time patients respond favorably and symptoms such as pain dissipate
–Over time these medications become ineffective and the patients develop hormonally resistant prostate cancer
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Treatment outlook for hormonally refractory prostate cancer

–Despite receiving medications to block testosterone, the disease progresses and the PSA rises
–Several treatments are available such as immunotherapy, oral agents, IV agents, and bone agents
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What is immunotherapy?

–For patients with asymptomatic or minimally symptomatic metastatic castrate-resistant (hormonally refractory) prostate cancer
–Involves treating your own immune cells, and activates portions of the immune system to fight the cancer
–Prolongs survival beyond 2 years in patients
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What are oral agents?

–Work by blocking enzymes in the liver that are involved with the synthesis of testosterone, or by blocking the site that androgens react with
–Extends survival
–Taken in conjunction with [LHRH medications](
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What are IV medications?

–Disturbs cell division
–Used in patients either failing oral therapies as well as prior to their usage in some
–Side effects potentially more significant than oral agents
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What are bone agents?

–Kills cancer cells in metastatic bone lesions
–Radioactive substance that is administered intravenously
–Prolongs life by over 4 months
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Talk to your doctor

Have an open line of communication with your doctor to talk about what treatment options might be the best for you.

NEXT: 10 Treatment Options for Prostate Cancer