Treating Advanced Prostate Cancer

Prostate cancer occurs when a tumor develops in the prostate gland, which makes the liquid portion of semen. Cancer that spreads outside the prostate gland to the lymph nodes, bones, or other areas is called metastatic or prostate cancer. Currently, no treatments can cure advanced prostate cancer. But doctors do have ways to help control its spread and related symptoms.

Treatments that slow the spread of advanced prostate cancer and relieve symptoms, however, often cause side effects. Some patients, often those who are older, decide that the risk of side effects outweighs the benefits of treatment. These patients may choose not to treat their advanced prostate cancer.

It's important to remember that researchers are always searching for new and better treatments that will cause fewer side effects, better disease control, and longer survival rates.

Chemotherapy

Until recently, hormone therapy was the only treatment approved for advanced prostate cancer. Recently that changed. Now, patients who no longer respond to hormone therapy have another option. In 2004, the FDA approved the chemotherapy drug Taxotere, taken with prednisone (a steroid), for the treatment of patients who no longer respond to hormone therapy. Taxotere works by preventing cancer cells from dividing and growing. Patients receive Taxotere, along with prednisone, through an injection. Side effects of Taxotere are similar to most chemotherapy drugs and include nausea, possible hair loss, and bone marrow suppression (the decline or halt of blood cell formation). Patients may also experience neuropathy (nerve damage causing tingling, numbness, or pain in the fingers or toes) and fluid retention.

Taxotere, when used with prednisone, is the first chemotherapy drug therapy proven to help some patients with advanced prostate cancer live longer. The average person prolonged life about 2.5 months but some men gained several years, according to studies. Researchers say it's an important breakthrough in care. "Before, we had no chemotherapy drug shown to improve survival in metastatic prostate cancer. Now we have one. We've got a good starting place," says Nancy Dawson, MD, professor of medicine and director of genito-urinary medical oncology at the University of Maryland Greenebaum Cancer Center.

Hormonal Therapy

Male hormones such as testosterone fuel the growth of prostate cancer. By reducing the amount and activity of these hormones, doctors can slow the growth of advanced prostate cancer. Hormone therapy is still the main treatment for advanced prostate cancer.

In many patients, hormone therapy provides temporary relief of symptoms of advanced prostate cancer. It also reduces tumor size and levels of prostate specific antigen (PSA) in most men. PSA is a substance produced by the prostate gland that, in excess amounts, signals the presence of prostate cancer.

But hormone therapy is not without risks. Some of the more serious side effects include loss of sex drive, impotence, and weakened bones (osteoporosis).

Eventually most patients with advanced prostate cancer stop responding to hormone therapy. Doctors call this hormone refractory prostate cancer.