Prostate Cancer: Treatment Options for Late-Stage Cancer
The treatment choices for prostate cancer depend on several things. These include your age, personal preferences and overall health, as well as the size and location of the cancer. Treatment also depends on lab test results and the stage of the cancer. When prostate cancer has spread to places in your body not near your prostate, it's called advanced or late-stage prostate cancer. This includes some stage III and all stage IV prostate cancers, as well as cancer that comes back after treatment. It's also called metastatic prostate cancer.
Learning about your treatment options
You may have questions and concerns about your treatment options. For example, you may want to know if treatment will affect your urinary or sexual function. You may also want to know if you’ll have to change your normal activities.
Your healthcare provider is the best person to answer your questions. He or she can tell you what your treatment choices are, how successful they’re expected to be, and what the risks and side effects might be. Your healthcare provider may advise a specific treatment. Or he or she may offer more than one option, giving you a choice. This can be a hard decision to make. Each type of treatment has different benefits and risks. You may want to learn all you can about your cancer and treatment choices so that you can make decisions about your care.
Talk with your healthcare provider to get answers to your questions. It’s important to take the time to make the best decision for you.
Types of treatment for late-stage prostate cancer
Hormone therapy (androgen deprivation therapy)
The goal of hormone treatment is to lower or block male hormones, such as testosterone, which can cause the cancer to grow. Hormone therapy may involve hormone shots done once a month or every few months. Pills can also be taken to help control hormones. Another way is to have surgery to remove the testicles. (The testicles make most of a man's testosterone.) Hormone treatment does not cure prostate cancer, but it slows its growth. Hormone therapy can be used alone, or it can be used with other treatments like radiation.
Radiation therapy can be done with external beam radiation therapy, also called EBRT. For this, a machine sends a beam of radiation to your prostate. Internal radiation, also called brachytherapy, may be used along with EBRT. To do this, tiny metal radioactive seeds are put into your prostate using thin, hollow needles. If your cancer has spread far from your prostate, such as to your bones, radiation therapy might be used to help ease pain or other symptoms. If the cancer has spread to many bones, you may have an injection of a liquid radioactive medicine instead.
Chemotherapy is the use of medicines to slow the growth of cancer and reduce symptoms. It’s most often used if cancer has stopped responding to hormone treatment. It might also be used along with hormone therapy as the first treatment. Chemotherapy does not cure the cancer. It can decrease the pain from with prostate cancer, shrink the tumor, lower the levels of prostate-specific antigen (PSA), and may help you live longer.
A vaccine is a type of medicine that can help boost the immune system. Vaccines are usually given to help protect the body against infections. There is a vaccine (sipuleucel-T) that can be used to boost the immune system to help treat prostate cancer. It is used to treat late-stage prostate cancer that is no longer reacting to hormone therapy, but is causing few or no symptoms. The vaccine does not cure prostate cancer. But it can often help men live longer.
If prostate cancer spreads, it often goes to the bones first. This can cause pain and other symptoms. Different types of medicines can be used to help slow the growth of the cancer in the bones and help relieve symptoms.
Talking with your healthcare providers
At first, thinking about treatment options may seem overwhelming. Talk with your healthcare providers and loved ones. Make a list of questions. Think about the benefits and possible side effects of each option. Discuss your concerns with your healthcare providers before making a decision.