Advanced Prostate Cancer: The Basics and Treatment Options

by Jay Motola, M.D. Health Professional

Patients with prostate cancer that is not localized to the prostate and has spread cannot 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.

Medications in a pharmacy.
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Hormonally sensitive prostate cancer

Responds to the elimination of the male hormone testosterone by various medications.

Doctor explaining treatments for hormonally refractory prostate cancer.
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Hormonally refractory prostate cancer

Does not respond to medications which eliminate the male hormone testosterone; other medications are now available to treat this kind of prostate cancer.

Doctor describing the outlook for hormonally sensitive prostate cancer.
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Treatment outlook for hormonally sensitive prostate cancer

–Patients are first put on medications known as LHRH antagonists, and possible antiandrogens.

–For a period of time patients respond favorably and symptoms such as pain decrease.

–Over time these medications become ineffective and the patients develop hormonally resistant prostate cancer.

Prostate-specific antigen test.
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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.

Immune cells attacking cancer cells.
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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

Senior man swallowing an oral agent for prostate cancer treatment.
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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

IV infusion medication to treat prostate cancer.
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What is IV medication?

–Disturbs cell division

–Used in patients either failing oral therapies or, for some, prior to their usage

–Side effects potentially more significant than oral agents

Man withdrawing bone agent from a vial to treat prostate cancer.
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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

Senior man discussing prostate cancer treatment options with his doctor.
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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.

Jay Motola, M.D.
Meet Our Writer
Jay Motola, M.D.

Jay Motola, MD, is a board-certified urologist and attending physician, Department of Urology, Mount Sinai West, and Assistant Professor of Urology, Icahn School of Medicine at Mount Sinai. Dr. Motola is a summa cum laude, Phi Beta Kappa graduate of Boston University, and earned his medical degree at the State University of New York at Stony Brook.