Prostate Cancer Health Center

Advanced Prostate Cancer: Frequently Asked Questions

If you just learned that you or a loved one has advanced prostate cancer, you may have many questions and concerns. By taking the time to research your condition, you've taken a good first step. Here are answers to the most common questions. After looking over these answers, click on other articles in this guide to find in-depth information about treatments, side effects, and other issues that affect you and your family.

What is advanced prostate cancer?

Prostate cancer is defined as 'advanced' when it spreads outside the prostate gland. It may spread to nearby tissues, lymph nodes, bones, or other parts of the body. It is also called metastatic prostate cancer.

Can advanced prostate cancer be cured?

No cure exists for advanced prostate cancer. However, treatments can help. Some treatments slow the growth of the cancer. Others reduce symptoms caused by the disease.

Prostate cancer grows in response to male hormones in the body, such as testosterone. That’s why one of the first treatments for advanced prostate cancer is to decrease these hormone levels (called androgen deprivation therapy). There are several medications that can do this. The most frequent side effects from hormone therapy include reduced sex drive, impotence, infertility, and bone loss. Most men develop erectile dysfunction and infertility. Your doctor may be able to help prevent some side effects, such as bone loss.

Rarely, doctors recommend surgical removal of the testicles to decrease hormone levels. This is usually not necessary since medications typically work. 

If hormone therapy fails to slow the growth of the cancer, the next step may be a prostate cancer "vaccine" called Provenge. Most men who take Provenge survive at least 2 years after starting the treatment. 

Provenge isn't your everyday vaccine. It's a therapy created by taking immune cells from a patient, genetically engineering them to fight prostate cancer, and then putting them back into the patient. It's used for men with few or no symptoms and when advanced prostate cancer no longer responds to hormone therapy. 

Though relatively new, Provenge appears to be remarkably safe. However, clinical trials suggested the treatment might cause a slightly increased risk of stroke. The most common side effect is chills, which occurs in most men. Other common side effects include fatigue, fever, back pain, and nausea.

Chemotherapy is another option when hormone therapy stops working. Only a few chemotherapy medications have been shown to work for advanced prostate cancer. The chemotherapy drug Taxotere, when taken with the steroid prednisone, can help extend survival by nearly two years in some men. When Taxotere stops working, the chemotherapy drug called Jevtana can help extend survival in some men. Possible side effects of Taxotere include nausea, hair loss, and decreased production of blood cells. Men may also develop fluid retention and pain, tingling, or numbness in the fingers or toes. Jevtana has side effects similar to Taxotere.