The treatment choices for prostate cancer depend on several things. These include your age and overall health, and the size and location of the cancer. They also include lab test results and the stage of the cancer. When prostate cancer has spread to places in your body not near your prostate, it's called advanced or late-stage prostate cancer. It's also called metastatic prostate cancer.
Learning about your treatment options
You may have questions and concerns about your treatment options. For instance, you may want to know if treatment will affect your urinary or sexual function. You may also want to know if you’ll have to change your normal activities.
Your cancer specialist (oncologist) is the best person to answer your questions. They can tell you what your treatment choices are, how successful they’re expected to be, and what the risks and side effects are. Your healthcare provider may advise a specific treatment. Or they may offer more than 1, giving you a choice. This can be a hard decision to make. Each type of treatment has different benefits and risks. You may want to learn all you can about your cancer and treatment choices so that you can make decisions about your care.
Talk with your healthcare provider to get answers to your questions. It’s important to take the time to make the best decision for you.
Types of treatment for late-stage prostate cancer
Hormone therapy (androgen deprivation therapy)
The goal of hormone treatment is to lower or block male hormones, such as testosterone. These types of hormones cause the cancer to grow. They can be blocked in a few ways. One way is through hormone shots. These are done once a month or every few months. Another way is to have surgery to remove the testicles. The testicles make testosterone. Pills can also be taken to help control hormones. These aren’t often used on their own. Hormone treatment does not cure prostate cancer, but it slows its growth. Hormone therapy can be used alone, or it can be used with other treatments like radiation.
If your cancer has spread far from your prostate, such as to your bones, you may be given radiation therapy to help ease pain or other symptoms. This can be done with external beam radiation therapy (EBRT). For this treatment, a machine sends a beam of radiation to the bones causing your pain. If the cancer has spread to many bones, you may have an injection of a radioactive medicine instead.
Chemotherapy is the use of medicines to slow the growth of cancer and reduce symptoms. It’s most often used if cancer has stopped responding to hormone treatment. It might also be used along with hormone therapy as the first treatment. Chemotherapy doesn't cure the cancer. It can decrease the pain from prostate cancer, shrink the tumor, lower your levels of prostate-specific antigen (PSA), and may help you live longer.
A vaccine is a type of immunotherapy that can help boost the immune system. Vaccines are usually given to help protect the body against infections. There is a vaccine (sipuleucel-T) that can be used to boost the immune system to help treat prostate cancer. It's used to treat late-stage prostate cancer that is no longer reacting to hormone therapy but that is causing few or no symptoms. The vaccine doesn't cure prostate cancer. But it can often help men live longer.
Targeted therapy uses medicines that attack cancer cells while doing little harm to normal cells.
Rucaparib and olaparib are a type of targeted therapy. They are called PARP inhibitors. They may be used in some men who have a genetic mutation called BRCA. These medicines are pills taken twice a day.
If prostate cancer spreads, it often goes to the bones first. This can cause pain and other symptoms. Different types of medicines can be used to help slow the growth of the cancer in bones and help relieve symptoms. These medicines include bisphosphonates that are given by IV every 1 to 3 months. They're often given with calcium and vitamin D supplements.
Talking with your healthcare providers
At first, thinking about treatment options may seem overwhelming. Talk with your healthcare providers and loved ones. Make a list of questions. Think about the benefits and possible side effects of each option. Discuss your concerns with your healthcare providers before making a decision.