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Prostate Cancer: Latest Treatments and Emerging Therapies

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What are the complications and side effects of surgery for advanced prostate cancer?

As with surgery for early-stage prostate cancer, surgery for more advanced cancers can have significant side effects. Those include erectile dysfunction, urinary incontinence, and fecal incontinence.

Can radiation therapy be used for advanced prostate cancer?

External-beam radiation therapy can help control the growth of localized tumors. It can also help men live longer without symptoms of disease. Brachytherapy (radiation seeding) is technically difficult to do in large prostate tumors. So it is less often used in men with advanced disease.

External beam radiation can also be an effective method for controlling disease that recurs after radical prostatectomy. The radiation is directed to the part of the body where the diseased prostate was removed. Brachytherapy cannot be used in this case because the gland has been taken out. That leaves no place to embed the seeds.

Some men's tumors are not diagnosed until they have reached stage III or higher. When that's the case, whether radiation therapy will be effective depends on the status of regional lymph nodes. If the nodes are removed and appear to be disease-free, the chance for long-term survival is much better than if they have cancerous cells.

Radiation can also be delivered through a monthly intravenous drug called Xofigo. Xofigo is approved for use in men who have advanced prostate cancer that has spread only to the bones. Candidates should have also received therapy designed to lower testosterone. The drug works by binding to minerals within bones to deliver radiation directly to bone tumors. A study of 809 men showed that those taking Xofigo lived an average of 3 months longer than those taking a placebo.     

What are the complications and side effects of radiation in treating advanced stage prostate cancer?

Common complications of radiation therapy include erectile dysfunction and urinary incontinence.

Impotence and urinary problems may occur in men treated with radiation therapy. Other complications may include:

  • Short-term bladder infections
  • Infections of the lining of the anus
  • Intestinal infections

Some men experience fatigue after multiple radiation sessions.

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