Advanced prostate cancer

There's still much hope

Advanced prostate cancer means that the cancer has moved beyond the prostate gland. It is no longer considered to be localized cancer, which is a term that means the cancer it is not confined to the prostate gland. 

While it can be discouraging to receive this kind of diagnosis, take heart in knowing that there are still many treatment options that you can discuss with your doctor.

Advanced prostate cancer may further be defined as locally advanced, regionally advanced, or metastatic cancer.   Read below to learn what these terms mean to you.  

Locally advanced cancer: This means the cancer has spread to tissues near the prostate gland, such as the seminal vesicles, or organs near the prostate, such as the bladder or rectum.

Regionally advanced cancer: This refers to cancer that has spread beyond the prostate to the nearby lymph nodes.

Metastatic cancer: This means the cancer has spread to other areas of the body, such as the lymph nodes and/or bones. Learn more.

Options for advanced prostate cancer

The suggested treatment options for a man with advanced cancer are likely to be different than for a man with localized cancer.  But the good news is that there are still multiple treatment options so try to maintain hope. 

It is also key to learn as much as you can about each treatment option.  Every man is different and it's important to discuss the pros and cons of each treatment option with your doctor. 

If the cancer is believed to be localized to the area where the prostate gland is located, there is still a chance it may be cured, according to the American Cancer Society.  The type of treatment option often depends on several factor, such as how quickly the PSA level is rising and the Gleason score at the initial diagnosis. 

Common treatment options for cancers that have spread outside of the prostate gland, but have not reached the bladder or rectum

Some types of treatment to discuss with your doctor include:

  • External beam radiation therapy (EBRT) plus hormone therapy
  • EBRT plus brachytherapy and possibly short-term hormone therapy
  • Hormone therapy alone
  • Radical prostatectomy
  • Cryosurgery
  • Active surveillance, particularly if a man has other serious health issues and cannot undergo surgery or other treatments

While the traditional protocol has always been to not use chemotherapy until hormone therapy has failed, you can ask about using it earlier as recent studies  about using chemotherapy along with hormone therapy have been promising.

Common treatment options for cancers that have spread to the bladder, rectum, or other areas

  • Hormone therapy
  • EBRT plus hormone therapy, in some cases
  • TURP surgery to relieve symptoms like bleeding or urinary obstruction
  • Chemotherapy (usually used after hormone therapy has failed, but you can ask about using it earlier in combination)
  • Active surveillance, if a man has other serious health issues that prevent him from undergoing other treatments
  • Participating in a clinical trial of newer or perhaps experimental treatments, including vaccines and monoclonal antibodies (usually after hormone therapy has failed)

Other treatments may also be used to help lessen uncomfortable symptoms, such as bone pain.  You may hear this described as palliative treatments or palliative care. 

Next: Prostate cancer statistics

Disease 101
What is prostate cancer?
What are the causes?
Symptoms
PSA testing
Digital rectal exam
Diagnosis
Gleason score
Staging

Always consult a medical professional.

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References:

Bostwick DG, Crawford DE, Higano CS, Roach M, eds. American Cancer Society’s Complete Guide to Prostate Cancer. Atlanta, GA: American Cancer Society Health Promotions; 2005.

The American Cancer Society. Prostate Cancer. http://www.cancer.org. Accessed March 17, 2015.

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