How to Choose Advanced Prostate Cancer Treatments

Medically Reviewed by Laura J. Martin, MD on December 13, 2016
3 min read

You have lots of choices for treatment for advanced prostate cancer. The FDA has approved several new therapies in the last several years, and more are being developed. The challenge is figuring out which treatments are best for you.

"Since we have so many tools in our toolbox now, it's important to really engage in a conversation with your oncologist about how to maximize those tools," says Heather Cheng, MD, PhD, director of the Seattle Cancer Care Alliance Prostate Cancer Genetics Clinic.  

There are several important things to consider while you decide your course of action.

It's important to think about your quality of life as you weigh your options. Ask your doctor about the risks and benefits of each treatment you're considering. Learn about the possible short- and long-term side effects of the medications.

Find out about risks of drugs, like muscle weakness or nausea, and compare them with how the drug will help.

Always feel free to talk about the expense of treatment with your doctor. If they don't bring it up first, you might want to say something along the lines of: "I'm worried about the cost of my cancer treatment. Can we talk about my concerns?"

Ask who handles health insurance issues at the hospital or medical center and how you might get financial help.

"These treatments are expensive," says Manish Kohli, MD, a professor of oncology at the Mayo Clinic, "so we take into account whether a patient has insurance to pay for it. If he doesn't, I'll write to the compassionate care programs. I'll explain that while we have other options like chemotherapy, this patient probably is not going to be able to tolerate those as well, so we should consider this newer, more expensive treatment."

Does prostate cancer run in your family? If so, that might influence the treatment plan that you and your doctor choose.

A study in The New England Journal of Medicine found that more than 10% of men with advanced prostate cancer have a genetic mutation (change) that raises the chance of having cancer. Learn about your family history, and ask your doctor how that may affect your treatment options.

Think about how the treatment you choose affects your daily routine. Ask yourself questions like:

  • Will I need to leave work early to get treatment?
  • Will I have to arrange for transportation to get to the treatment center?
  • Does the treatment work with my caregiver's job and schedule?

No treatment -- no matter how cutting-edge -- will work if you can't stick to it. Talk it over with your doctor. "Some treatments have schedules that are more flexible," Cheng says.

How well you handle a particular treatment depends on your overall health. The average age at diagnosis of prostate cancer in the U.S. is about 66. And men with advanced prostate cancer are about 10 years older when they get diagnosed, Kohli says. At that age, you're more likely to have long-term health conditions like heart disease and diabetes, and that can complicate cancer treatment.

During your treatment, it's important to get caregivers to help out. That doesn't always mean someone you hire. Family and friends can be a huge help. Also ask your doctor about local organizations that offer low-cost or free home care or other services.

Show Sources


Memorial Sloan Kettering Cancer Center: "Prostate Cancer: Systemic Therapies."

Heather Cheng, MD, PhD, director, Seattle Cancer Care Alliance Prostate Cancer Genetics Clinic.

Manish Kohli, MD, professor of oncology, division of medical oncology, Mayo Clinic.

American Society of Clinical Oncology: "Making Decisions About Cancer Treatment," "Questions to Ask About Cost," "Cancer Care Decisions for Older Adults."

Pritchard, C. The New England Journal of Medicine, Aug. 4, 2016.

American Cancer Society: "Key Statistics for Prostate Cancer."

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