Hormone Therapy
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A patient whose prostate cancer has spread beyond the prostate or has recurred after treatment often receives hormonal therapy. These treatments usually reduce levels of testosterone in the patient, as testosterone can stimulate the growth of prostate cancer cells. Physicians may surgically remove the source of male hormones, the testicles (a procedure called an orchiectomy), or -- more commonly -- administer drugs that reduce the body's testosterone production. Some patients may receive what is termed intermittent hormone therapy. In such cases therapy is given for a number of months, pushing PSA levels down and keeping the cancer in check; therapy is then suspended for a set period of time, during which impotence and other side effects diminish. Later, physicians begin the therapy again. For very aggressive prostate cancer, our specialists are integrating the use of chemotherapy and hormonal therapy with surgery or radiation therapy. Potential side effects of hormone therapy include reduced or absent feelings of sexual desire, impotence, weakness, fatigue, loss of muscle mass, growth of breast tissue, and hot flashes.
Chemotherapy
Chemotherapy is usually reserved for patients whose prostate cancer has spread outside of the prostate gland and for whom hormone therapy has failed. Chemotherapy for prostate cancer has been shown to prolong patients' lives, reduce pain from bone metastases, and enhance overall quality of life. The benefits of chemotherapy for advanced prostate cancer are comparable to the benefits seen in patients with other advanced solid tumors who receive chemotherapy. The agent now considered the standard of care for prostate cancer patients is docetaxel (Taxotere®), which is directed at the structural skeleton of the cell.
Bone-protecting treatments
The most common site of distant spread of prostate cancer is the bones. Most symptoms of advanced prostate cancer are caused by the presence of disease in the bone. These symptoms can be mitigated with a drug called zoledronic acid, which can slow the spread of disease, reduce the development of bone pain, inhibit bone fractures, and confer other beneficial effects. Zoledronic acid is most commonly given to patients whose cancer is no longer responding to hormones, but it may also be given to prevent the bone thinning and weakening that results from hormonal treatments.
