Advanced prostate cancer treatment

After reading this article, you will know

• when prostate cancer is considered advanced
• where in the body, prostate cancer can spread to
• what treatment options are available
• the chances of a cure

The extent of the disease affects how the treatment team will treat prostate cancer. There are many accepted ways to describe the stage of prostate cancer, but a simple one divides the cancer into three stages:

• localized
• locally advanced
• metastatic

When is prostate cancer considered advanced?

The prostate is a gland that is wrapped in a solid capsule of tissue. When prostate cancer is only located inside this capsule, it is called ‘localized’.

If the cancer grows and breaks through this capsule it can reach nearby organs like the bladder, rectum, or pelvic floor. This is called ‘locally advanced’ prostate cancer.

Prostate cancer can also spread to other body parts through the lymph channels and the blood vessels. This is called metastasis. Prostate cancer often metastasizes to the lymph nodes and bones. Sometimes it can also affect the liver, lungs, and brain.

How is locally advanced cancer treated?

There are different ways to treat prostate cancer that has spread outside the prostate gland. These treatments often work well. Your treatment team may suggest one of the following options:

• Surgery: Your treatment team removes the prostate and the surrounding tumor. This can cure the cancer if the surgery is successful.
• Radiation therapy: This kills the cancer cells in the area near the prostate. It is often combined with hormone therapy for a period of at least 24 or 36 months. This combination can help cure the cancer.
• Hormone therapy: These drugs make the cancer cells grow slower. Hormone therapy alone cannot cure cancer, but may be used when surgery or radiation therapy is not possible or not wanted. It may even be used in combination with radiation therapy or other therapies.

How are prostate cancer metastases treated?

There are different ways to manage prostate cancer that has spread to other parts of the body. These treatments may not cure the cancer, but they can slow it down and help you live longer. These therapies are used alone or in combination:

• Hormone therapy: These drugs block the effect of the male sex hormones that make the cancer cells grow faster.
• Chemotherapy: These drugs kill cancer cells that grow quickly and stop the tumor from spreading.
• Abiraterone and enzalutamide: These drugs target the male sex hormones. They lower the amount of testosterone in the body.

In summary

• Surgery and radiation therapy can work well for prostate cancer that has grown outside the prostate gland.
• If cancer has spread to other body parts, hormone therapies and chemotherapy can be used to target these metastases.

What you can do

• Talk to your treatment team about your options.
• Find a support group of people with prostate cancer or their caregivers.
• Talk to a mental health expert if you are feeling low or stressed.
• Get more information on prostate cancer, treatments, and resources.