Cancer that has spread beyond the prostate (advanced prostate cancer) cannot usually be cured. Treatment can be used to prolong life, improve quality of life, slow the spread of cancer, and relieve symptoms.
Treatment options for advanced prostate cancer include hormone therapy, radiation, chemotherapy, and surgery.
Hormone therapy involves reducing the levels of hormones such as testosterone (called androgens). This may be done using medications or surgery to remove the testicles (orchiectomy). Prostate cancer cells need androgens to grow. Hormone therapy won't cure the cancer, but it can decrease the size of the tumour.
Medications used for hormone therapy include:
These medications are designed to mimic the actions of gonadotropin releasing hormone (GnRH or LHRH), a hormone released from the brain that affects the production of testosterone. The medications work by turning off testosterone production. LHRH analogues available in Canada include:
- buserelin nasal (Suprefact®, Suprefact Depot®)
- goserelin subcutaneous (Zoladex®, Zoladex LA®)
- leuprolide (Eligard®, Lupron®, Lupron Depot®)
- triptorelin intramuscular (Trelstar®)
These medications work by blocking the effects of androgens (hormones like testosterone) on the prostate. They are used in combination with LHRH analogues or surgery. Antiandrogens available in Canada include:
- bicalutamide tablets (Casodex® and generics)
- cyproterone tablets (Androcur® and generics, Androcur Depot®)
- flutamide tablets (Euflex® and generics)
- nilutamide tablets (Anandron®)
To learn more about hormone therapy, see "Managing Advanced Prostate Cancer."
Radiation therapy delivers radiation to the tumour using an external beam or, occasionally, radioactive seed implants inserted surgically (called brachytherapy) to destroy cancer cells.
To find out more about radiation therapy for advanced prostate cancer, see "Managing Advanced Prostate Cancer."
Chemotherapy uses medications to kill cancer cells. It is used when prostate cancer returns, or to treat advanced prostate cancer that is no longer responding to hormone therapy. Chemotherapy medications are usually used in combinations called regimens because researchers have discovered that they work better this way. Regimens define what dosages of each medication are recommended and how often the medications should be given.
Chemotherapy medications used to treat advanced prostate cancer include:
- docetaxel (Taxotere®) - used in combination with prednisone or prednisolone
- mitoxantrone (generics) - used in combination with prednisone
To learn more about chemotherapy for advanced prostate cancer, see "Managing Advanced Prostate Cancer."
Surgery cannot cure advanced prostate cancer (except in cases where it is locally advanced), but it may be used to relieve symptoms and make the person more comfortable.
For more information on surgery for advanced prostate cancer, see "Managing Advanced Prostate Cancer."
Talk to your doctor about the risks and benefits of the various treatment options that are available to you. You should also ask your doctor what you can expect the treatment to do for you (e.g., improve survival, improve quality of life, slow the spread of cancer, or relieve symptoms). This will help in deciding which options are right for you. Each type of treatment can have side effects, but it's important to know that your side effects may be preventable, manageable, or reversible. Find out how to understand the side effects of your treatment.