Prostate Cancer, Advanced or Metastatic - Medications
Medicines may be used to slow the growth of
prostate cancer and to relieve your symptoms.
Prostate cancer needs the male hormone
testosterone to grow. Hormone therapy uses special
drugs to block the production or action of testosterone and may cause the
cancer to shrink. This can improve your symptoms. Hormone therapy may be given
before or after
surgery to remove the prostate.
Hormone therapy usually works well at
first to stop cancer growth. But in most cases the cancer returns in a few
years. At this point, the cancer is called hormone-resistant. This means it will no longer get better
with hormone therapy. When this happens, other kinds of hormone treatment may
work. If the cancer continues to grow, chemotherapy or immunotherapy may be the next choice.
Chemotherapy is the use of drugs to control cancer's
growth or relieve pain. Often the drugs are given through a needle in your
vein, and your blood vessels carry the drugs through your body. Sometimes the
drugs are available as pills you can swallow. Sometimes they are given through
a shot, or injection.
Chemotherapy usually involves two or more
drugs given together. Combinations may work better than a single medicine. That's because each drug can attack the cancer cells in a different way. This is most often used when prostate cancer
Immunotherapy is treatment that uses the body's
immune system to destroy the cancer cells. This is used for prostate cancer that is hormone-resistant.
- LH-RH agonists/GnRH agonists, such as goserelin (Zoladex) and leuprolide
- GnRH antagonists, such as degarelix (Firmagon).
- Antiandrogens, such as abiraterone (Zytiga), bicalutamide (Casodex), flutamide, and nilutamide
Hormone therapy is commonly used with radiation therapy. It may be used alone with metastatic cancer.
Chemotherapy may be helpful when prostate cancer no longer responds to hormone therapy.
Medicines for castrate-resistant prostate cancer (CRPC)
Medicines to treat CRPC include:
- Abiraterone (Zytiga), given with prednisone (both are pills).
- Chemotherapy with cabazitaxel (Jevtana), given by IV.
- Enzalutamide (Xtandi), given as pills.
- Immunotherapy with sipuleucel-T (Provenge), a vaccine given by injection.