Treatment For Advanced Prostate Cancer
Although advanced prostate cancer cannot be cured, it can be controlled with treatment, sometimes for several years. Treatments can also help relieve symptoms and improve your quality of life.
A multidisciplinary team will meet to discuss the best possible treatment for you. This will depend on different factors, like your general health. Your cancer doctor will talk to you about the advantages and disadvantages of these treatments.
The main treatments are:
- Hormonal therapy
Hormonal therapies reduce the amount of testosterone in the body. This may slow the growth of the cancer or stop it growing for a while.
- Chemotherapy
Chemotherapy uses anti-cancer drugs to destroy cancer cells. You may have it with hormonal therapy when you are first diagnosed with advanced prostate cancer. Or, it can be given when hormonal therapy is no longer controlling the cancer.
- Radiotherapy
Radiotherapy is most often used to shrink cancer that has spread to the bones. External beam radiotherapy uses high energy rays to destroy cancer cells. Its given using a large machine. Radioisotope therapy is a type of internal radiotherapy given as an injection.
- Surgery
Surgery to remove the prostate is not suitable for advanced prostate cancer. Surgery may be used to help control symptoms or to help stabilise a bone that is at risk of breaking.
Your doctor or nurse will usually ask you to sign a form giving your permission for them to give you the treatment. They cannot give treatment without your consent.
Us Preventive Services Task Force Issues New Prostate Cancer Screening Guidelines
Prostate cancer is usually though not always a very slow-growing cancer that takes a long time to start affecting the body.
Most often, it only causes symptoms when it grows to pinch the urethra or invade the sphincter or other body parts.
In fact, some men with prostate cancer dont show any signs or symptoms of their illness, the CDC notes.
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Other Professionals Who Can Help
Your doctor, nurse or GP can refer you to these professionals.
- Physiotherapists can help with mobility and provide exercises to help improve fitness or ease pain. This can help you stay independent for longer.
- Counsellors, psychologists or psychotherapists can help you and your family work through any difficult feelings and find ways of coping. Many hospitals have counsellors or psychologists who specialise in helping people with cancer. You can also get free counselling on the NHS without a referral from your GP. Visit nhs.uk/counselling to find out more.
- Dietitians can give you advice about healthy eating, which might help with fatigue and staying a healthy weight. They can also help if you are losing weight or having problems eating.
- Occupational therapists can provide advice and access to equipment and adaptations to help with daily life. For example, help with dressing, eating, bathing or using the stairs.
- Social services, including social workers, can provide practical and financial advice and access to emotional support. They can give you advice about practical issues such as arranging for someone to support you at home. Whats available varies from place to place. Your GP, hospital doctor or nurse might be able to refer you to some services. The telephone number for your local social service department will be in the phonebook under the name of your local authority, on their website and at the town hall.
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Managing Symptoms Of Advanced Prostate Cancer
Symptoms can often be improved by treating the cancer, but there are other ways to control symptoms. Tell your doctor or specialist nurse if you have new symptoms or symptoms get worse.
You may see a doctor or nurse who specialises in pain and symptom control. They are sometimes called palliative care specialists.
Some people find complementary therapies such as relaxation, gentle massage, or aromatherapy help you feel better and more in control.
Aggressive Treatment For Prostate Cancer Is The Norm
Study Finds Majority of Men Diagnosed With Low-Risk Disease Get Radiation or Radical Surgery
July 26, 2010 More than 75% of men diagnosed with low-risk prostate cancer undergo aggressive treatment either complete removal of the prostate or radiation therapy, according to a new study.
Thats true, the researchers found, even in men with a low level of prostate-specific antigen of under 4 nanograms per milliliter, one of the factors taken into account when treatment decisions are made.
If we knew for sure everyone with a PSA under 4 would not die of prostate cancer, case closed, says researcher Mark N. Stein, MD, a medical oncologist at The Cancer Institute of New Jersey and assistant professor of medicine at the UMDNJ-Robert Wood Johnson Medical School, New Brunswick.
But thats far from true, Stein says. And that makes the balance between overtreatment and undertreatment difficult, he says. The report is appears in the Archives of Internal Medicine.
The tremendous improvement in survival has been attributed to early detection and treatment, Stein and his colleagues write. However, there have been concerns about the potential overdiagnosis and overtreatment of localized prostate cancer.
In the study, they looked at data from nearly 124,000 men with newly diagnosed prostate cancer from 2004 to 2006 to determine which men received aggressive treatment.
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Look Out For These Warning Signs Of Prostate Cancer
Prostate cancer is the most common cancer among men in the United States. Nearly 200,000 men are diagnosed every year. Thanks to research and innovation, prostate cancer is also one of the most treatable cancers. In some cases, the cancer doesnt pose an immediate threat to patients due to slow growth. However, for some, the cancer can spread quickly and affect surrounding organs. Understanding the warning signs and risk factors is vital.
As with any cancer, early detection is key in increasing your ability to fight prostate cancer. To discuss the warning signs, we spoke with Suraj Singh, MD, a radiation oncologist at Banner MD Anderson Cancer Center at North Colorado Medical Center. He explained that early signs for prostate cancer can be subtle. Often, patients dont feel symptoms until the cancer is more advanced. Its just as important to understand your risk factors, said Dr. Singh, so that you take steps to find the cancer before you ever start feeling its effects.
Risk factors include age, family history, race, diet, race and other health issues. Banner MD Anderson recommends men start a conversation with their doctor about the risks and benefits of prostate cancer screening at age 45.
Detecting Prostate Cancer With Psa Screenings
Now that we have PSA screening, it means that it is practically impossible for undiagnosed prostate cancer to cause discomfort, urinary problems, difficulty with erections, or any other symptom related to prostate cancer. This is not to say that men cant have prostate symptoms from noncancerous causes, such as prostatitis, benign glandular swelling, urinary tract infections, or sexually transmitted diseases. But PSA testing can ensure that any symptoms that may be present are coming from something unrelated to prostate cancer.
Cancer is such a frightening word that I feel compelled to draw attention to the widely false reporting that prostate cancer causes symptoms. So if prostate cancer is practically guaranteed to have no symptoms, assuming the PSA has been tested and is in the normal range, why do websites provide a long list of symptoms caused by prostate cancer? How can so much misinformation exist?
Basically, these websites hark back to a bygone era, describing a situation that existed before PSA testing was available. The symptoms they list, like bone pain, changes in urination, fatigue, pelvic pain, only occur in men with advanced disease. These websites are not acknowledging that men with normal PSA levels are unable to harbor advanced disease.
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To Treat Or Not To Treat
Up until now, with a few notable exceptions, doctors have myopically focused on treating prostate cancer, says Adami. They are willing to spend tens of thousands of dollars on chemotherapy that has minimal effects on cancer mortality, often with substantial side effects. But we ignore entirely the fact that large groups of prostate cancer patients die from other causes that actually are preventable.
Among older patients especially, that activity can take the form of vigorous walking. Recently, Mucci has spearheaded an intervention with Adami and other colleagues in Sweden, Iceland, and Ireland in which men walk in groups with a nurse three times a week. In a pilot study, researchers found improvements in just 12 weeks in body weight, blood pressure, sleep, urinary function, and mental health.
Scientists at HSPH are also searching for genetic and lifestyle markers that help predict how aggressive a patients prostate cancer will be. For example, an ongoing project led by Mucci and Adami draws on detailed cancer registries in Nordic countries, including an analysis of 300,000 twins, to tease out the relative contribution of different genes to prostate cancer incidence and survival.
is a Boston-based journalist and author of The Coke Machine: The Dirty Truth Behind the Worlds Favorite Soft Drink.
Trying New Potential Treatments
You may also want to talk to your doctor about taking part in a clinical trial. These are studies that test treatments to see if theyâre safe and if they work. They might be new drugs or a mix of treatments that haven’t been used together before. You could also be part of the “control” group and not get the new treatment at all. Clinical trials offer you early access to brand new treatments, but itâs also important to remember that they may not work. Youâll want to talk with your doctor to make sure you understand the pros and cons of a research study before you join one. To find clinical trials, ask your doctor or search the National Institutes of Health database at www.clinicaltrials.gov.
At some point, your treatment may stop working. If that happens, you can still get care to ease symptoms like nausea, pain, and tiredness. Even though it may not cure your cancer, the goal is to make you feel better.
Show Sources
American Cancer Society: “Hormone therapy for prostate cancer,” “Preventing and treating prostate cancer spread to bones,” “Vaccine treatment for prostate cancer,” “What is metastatic cancer?” “When Cancer Doesn’t Go Away,” âUnderstanding Advanced and Metastatic Cancer,â âWhatâs New in Prostate Cancer Research?â
Prostate Cancer UK: âWhat is locally advanced prostate cancer?â
ClinicalTrials.gov: “Learn About Clinical Studies.”
National Cancer Institute: “Cancer Vaccines.”
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Further Treatments To Control The Cancer
Your first treatment may help keep your cancer under control. But over time, the cancer may change and start to grow again. If this happens you might be offered other treatments, including:
- more hormone therapy
- clinical trials
More hormone therapy
Your prostate cancer may respond well to other types of hormone therapy, such as abiraterone , enzalutamide , steroids or oestrogens, or to a combination of treatments.
More chemotherapy
If youve had hormone therapy on its own as a first treatment, you might be offered a chemotherapy drug called docetaxel . This may help some men to live longer, and can help to improve and delay symptoms. If youve already had docetaxel, you might be offered more docetaxel or another chemotherapy drug called cabazitaxel .
Radium-223
This is a type of internal radiotherapy that may be an option if your cancer has spread to your bones and is causing pain. A radioactive liquid is injected into your arm and collects in bones that have been damaged by the cancer. It kills cancer cells in the bones and helps some men to live longer. It can also help to reduce bone pain and delay some symptoms, such as bone fractures. Read more about radiotherapy for advanced prostate cancer.
Stage 1 Prostate Cancer Treatment
Where stage 1 prostate cancer patients are of an advanced age, a watch and wait approach* is usually chosen over conventional medical treatment. This is because tumors can be slow growing at this early first stage and the survival rate is very high. For example, a person over 80 years old who is diagnosed with stage 1 prostate cancer could be more likely to die from other causes. Treatment could mean the benefits are outweighed by negative side effects. *also referred to as watchful waiting
However, in cases where a younger person has been diagnosed with first stage prostate cancer, there may be more immediacy in treating the disease rather than monitoring it. A younger person will have more years ahead of them in which the cancer can develop, and they may also make a better recovery following medical treatment.
When treatment is given, the treatment options are similar to those for stage 2 prostate cancer. The prostate gland may be removed through a procedure known as a radical prostatectomy. Radiation therapy and hormonal therapy may also be administered to shrink any tumors.
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What Are The Symptoms Of Prostate Cancer In Dogs
The symptoms of prostate cancer in dogs are related to the urinary tract significant increase in urination frequency but with small amounts of urine production, urinary incontinence, blood in urine, increased thirst .
However, these symptoms become apparent in dogs with advanced disease. In its early stages, canine prostate cancer is asymptomatic. Also, many symptoms are non-specific, thus disabling early detection of the problem.
Here are some of the clinical signs pet owners can expect in dogs with prostate cancer:
- Pain in the lumbar spine .
These clinical signs are not exclusive to prostate cancer in dogs. However, they must be taken seriously. If your dog is showing one or more of these signs and symptoms, call your trusted veterinarian.
How Is Stage I Prostate Cancer Treated
As the cancer is small and is confined to the prostate gland and the growth and spread may be slow and it may never show symptoms. The course of action depends on the age of the patient and their overall health and if they can withstand the treatment. The following are the treatment methods generally preferred for stage I prostate cancer treatment:
Active surveillance:
Because this cancer type grows very slowly, men may often not require any treatment immediately if not throughout their lifetime. Active surveillance is a method of monitoring the cancer closely regularly. PSA blood test, DRE , prostate biopsies may be done once in six months or so. If the results show signs of the cancer spreading, the treatment options are reviewed to eliminate the cancer.
Radiation therapy:
This treatment uses high beams of x-rays to kill the malignant cells. The radiation is aimed at the cancer cells to kill them, restrict their growth and to shrink tumours. The two main types of radiation therapy used in the treatment of prostate cancer:
Radical prostatectomy:
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How The Study Was Performed
During the study, scientists randomized 1,071 men with intermediate- or high-risk localized prostate cancer into four groups. One group received radiation and six months of an anti-testosterone drug called leuporelin, and the second group received radiation plus 18 months of leuporelin therapy. Two other groups were treated with the same regimens of either radiation plus six or 18 months of leuporelin therapy, along with another drug called zoledronic acid, which helps to limit skeletal pain and related complications should cancer spread to the bones. Study enrollment occurred between 2003 and 2007 at 23 treatment centers across New Zealand and Australia.
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Prostate Cancer Symptoms Explained As Joe Exotic Says He Has Aggressive Form Of Disease
Joseph Maldonado, better known as Joe Exotic, has been diagnosed with an aggressive form of prostate cancer, according to a letter written by the Tiger King figure.
A letter provided to CNN by his attorney John M. Phillips, Maldonadowho rose to fame in the 2020 Netflix documentary series Tiger King: Murder, Mayhem, and Madnesssaid a prostate biopsy had been returned with the diagnosis of aggressive cancer.
The tiger enthusiast, convicted in 2019 on animal abuse charges and for his role in a plot to murder longstanding rival animal rights activist Carole Baskin, added: I am still waiting on the results from other tests as well. Right now, I dont want anyones pity.
His attorney told CNN: The PSA test is a blood test used primarily to screen for prostate cancer. It was high. He finally obtained biopsies. They revealed cancer. Medical care is different in a prison environment and fewer options are available.
According to the American Cancer Society, aside from skin cancer, prostate cancer is the second most common form of cancer in American men, 1 in 8 men will be diagnosed with the condition.
Prostate cancer is also the second-leading cause of death in American men after lung cancer, with estimates suggesting that 1 in 41 men in the U.S. will die as a result of the condition.
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Loss Of Libido And Erectile Dysfunction
The hormones that are often used to treat advanced prostate cancer can decrease libido and cause erectile dysfunction , which occurs when a man isnt able to have or keep an erection to have sex, according to the University of Rochester Medical Center in Rochester, New York.
As a result, for couples, theres a real struggle to recover that sense of life together how to be intimate without having sex, says Michael J. Morris, MD, an oncologist at Memorial Sloan Kettering Cancer Center in New York City.
Depending on the type of treatment that caused the ED, the ability to have an erection may improve over time, according to the University of Rochester Medical Center. You and your partner may want to explore other ways to be intimate in your relationship. A sex therapist or couples counselor may be able to help. There are also treatments available for erectile dysfunction, such as medications and implants.