Stage IV Prostate Cancer Treatment
Palliative radiation therapy
A single fraction of 8 Gy has been shown to have similar benefits on bone pain relief and quality of life as multiple fractions (3 Gy × 10) as evidenced in the RTOG-9714 trial.; [Level of evidence: 1iiC] (Refer to the PDQ summary on Pain for more information.)
Palliative surgery with transurethral resection of the prostate (TURP)
Transurethral resection of the prostate may be useful in relieving urinary obstruction as part of palliative care in advanced prostate cancer.
Watchful waiting or active surveillance
Careful observation without further immediate treatment (in selected asymptomatic patients).
Treatment Options Under Clinical Evaluation for Stage IV Prostate Cancer
Treatment options under clinical evaluation include the following:
- Radical prostatectomy with immediate orchiectomy.
- An uncontrolled, retrospective review of a large series of patients with any T, N1–3, M0 disease treated at the Mayo Clinic with concurrent radical prostatectomy and orchiectomy was associated with intervals to local and distant progression; however, increase in overall survival has not been demonstrated. Patient selection factors make such study designs difficult to interpret.
Current Clinical Trials
Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with stage IV prostate cancer. The list of clinical trials can be further narrowed by location, drug, intervention, and other criteria.
General information about clinical trials is also available from the NCI Web site.
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