Hope for Advanced Prostate Cancer

Of the more than 200,000 men diagnosed with prostate cancer each year 5 -10% will already have advanced disease.  In addition, some men may develop a recurrence of their cancer despite initial attempts at curative therapy such as surgery or radiation therapy. Today there are more effective treatment options and a significantly better prognosis for those with advanced prostate cancer than ever before.  However, advanced prostate cancer is a complex disease and it is extremely important that men work closely with a prostate cancer specialist to develop a treatment plan specific to their health and lifestyle.   Advanced prostate cancer is a very personal disease.   Not all treatment options may be the best option for you.  Before deciding on any treatment plan – you need to have a frank discussion with a specialist who can guide you through the risks and benefits of the alternatives for your personal situation and health condition. 

Types of Advanced Prostate Cancer

Locally Advanced Prostate Cancer occurs when cancer has grown to fill the prostate or grown through the prostate and extended into the glands that help produce semen (seminal vesicles), or even into the bladder.

Biochemically Recurrent Prostate Cancer (Rising PSA) happens in men who have a rising PSA after treatment, but do not show any evidence that the disease has spread to bone or other organs. This can occur after local treatment, or after hormone therapy.

Metastatic Prostate Cancer (Hormone Sensitive) occurs when cancer has spread or “metastasized” to the bones, lymph nodes or other parts of the body.

Castrate Resistant Prostate Cancer (CRPC) is prostate cancer that continues to grow despite the suppression of male testosterone that fuels the growth of prostate cancer cells.

Advanced Therapies for Advanced Disease

Today there are targeted therapies designed to improve the prognosis and quality of life of patients with advanced or recurrent prostate cancer.  These include Hormonal Therapy/ Androgen Deprivation Therapy (ADT) to lower your body’s level of testosterone.  Because testosterone fuels the growth of prostate cancer cells – reducing or eliminating this hormone in the body helps stem the progression of the disease.  There are several methods for diminishing hormone levels including surgical and drug treatments.   Some common drug therapies include:

  • LHRH (luteinizing-hormone releasing hormone) Antagonists – drugs that interfere with the brain’s signal to body to produce hormones and shut down the production of testosterone.
  • LHRH (luteinizing-hormone releasing hormone) Agonists – drugs that initially boost hormone production for a few weeks and then block the production of testosterone at the level of the testicle.
  • Anti-Androgen Therapy – blocks the testosterone receptors in prostate cells preventing testosterone from fueling or stimulating the cancer cells.
  • Combined Androgen Blockade (CAB) – combines the anti-androgen and LHRH therapies listed above.
  • Chemotherapy – cancer killing drugs for those whose cancer has metastasized or become resistant to hormone therapy.
  • Immunotherapy (PROVENGE) used to boost the body’s immune system to fight cancer and infections.
  • Estrogen Hormones – the female hormone estrogen is used to decrease male hormone levels.