| Q1: What are the treatment options for | | | | advantageof 2.5 months over prednisone and |
| advanced prostate cancer? | | | | the chemotherapy drug mitoxantrone, which are |
| | | | FDA-approved to relieve pain in men with |
| Advanced prostate cancer is cancer that has | | | | hormone-refractory prostate cancer. |
| spread from the prostate to the pelvic lymph | | | | |
| nodes or to other parts of the body. Advanced | | | | Side effects of chemotherapy include nausea |
| prostate cancer cannot be cured but the | | | | and vomiting, fatigue, infection risk, hair |
| progression of the disease can be slowed and | | | | loss and tingling and numbness in the hands |
| men can be made more comfortable with | | | | and feet. People who experience side effects |
| hormonal therapy and, occasionally, | | | | from chemotherapy, however, can |
| chemotherapy. | | | | takemedications to combat nausea and vomiting |
| | | | and low blood counts that lead to fatigue and |
| Hormonal therapy is currently the first | | | | infection. |
| treatment that is recommended to men with | | | | |
| advanced prostate cancer. The goal of | | | | Q4: What therapies can I take to control |
| hormonal therapy is to lower levels of male | | | | prostate cancer symptoms? |
| hormones, or androgens, such as testosterone, | | | | |
| which can fuel the growth of prostate cancer. | | | | Men with advanced prostate cancer may |
| This can be achieved with eithersurgery or | | | | experience symptoms of their disease, such as |
| medication. | | | | pain, that require treatment to make them |
| | | | feel more comfortable. |
| Testosterone levels can be reduced surgically | | | | |
| by removing the testicles in an outpatient | | | | External radiation treatments might be |
| procedure known as an orchiectomy; prosthetic | | | | delivered periodically to shrink tumors and |
| testicles may be used in the testicles' | | | | help to relieve pain. |
| place. | | | | |
| | | | A group of drugs called bisphosphonates can |
| If a patient prefers medication to surgery, | | | | also be used to ease pain from cancer that |
| drugs such as LHRH agonists may be given as | | | | has traveled to the bones; these drugs may |
| shots every few months to lower testosterone | | | | also help prevent bone metastases. |
| levels. Other drugs, such as anti-androgens | | | | |
| and estrogen therapy, can help block the | | | | Pain can also be managed with painkillers and |
| activity of male hormones. Sometimes surgery | | | | non-drug methods. Some men might try |
| and medications are tried in combination. | | | | complementary therapies, such as acupuncture, |
| | | | herbal therapies or meditation; it's |
| Side effects of hormonal therapy include | | | | important to tell your doctors about the |
| impotence, low sex drive, tiredness, hot | | | | complementary therapies you are considering |
| flashes and weight gain. While hormonal | | | | since there are risks for drug interactions |
| therapy can lead to remissions up to two or | | | | and side effects. |
| three years, it cannot stave off the | | | | |
| progression of advanced prostate cancer | | | | Q5: Should I consider a clinical trial? |
| indefinitely and the disease usually returns. | | | | |
| | | | Clinical trials are studies conducted in |
| Q2: How will I know if hormonal therapy is | | | | people to evaluate new methods and |
| working? | | | | medications for safety and effectiveness. |
| | | | |
| The main way to determine whether hormonal | | | | Many ongoing trials are investigating new |
| therapy is working is by measuring | | | | approaches to treating advanced prostate |
| prostate-specific antigen (PSA) levels with a | | | | cancer, including cryosurgery, which uses |
| blood test. Blood levels of this protein can | | | | liquid nitrogen to kill prostate cancer |
| measure the presence and activity of prostate | | | | cells, as well as new chemotherapy |
| cancer. | | | | combinations and new approaches to radiation |
| | | | therapy. |
| So if PSA levels are going up, that's usually | | | | |
| a sign that the treatment isn't working as | | | | You should discuss the risks and benefits of |
| well as it has been. | | | | participating in a clinical trial with your |
| | | | doctor. |
| There are rare instances when the PSA may not | | | | |
| go up as the cancer is growing. In those | | | | Tips on how you can prepare for this |
| cases, people usually have symptoms, such as | | | | discussion: |
| bone pain, which should be evaluated with | | | | |
| X-rays. Some doctors may monitor for | | | | Get a three-ring binder for all of your |
| metastases with CT scans, MRIs or bone scans. | | | | medical documents. |
| | | | |
| Q3: What can be done if the hormonal options | | | | Get copies of all of your laboratory and |
| don't work? | | | | pathology reports. |
| | | | |
| When someone has advanced prostate cancer | | | | Bring a note pad, tape recorder or a friend |
| that is no longer responding to hormonal | | | | as another set of ears to your doctor's |
| therapies-a condition known as | | | | appointments to be sure you do not miss any |
| hormone-refractory prostate cancer-other | | | | of the information. |
| forms of treatment may be required. | | | | |
| | | | Make a list of all medications and |
| Until recently, chemotherapy, which kills | | | | complementary therapies you are taking. |
| fast-growing cells typical of most cancers, | | | | |
| was not thought to work against prostate | | | | Consider your goals for treatment. |
| cancer cells, which are usually slow growing. | | | | |
| Even though chemotherapy was sometimes used | | | | If considering hormonal therapy, consider |
| to relieve pain in men with | | | | whether you prefer surgery or medications |
| hormone-refractory prostate cancer, it had | | | | that will suppress your hormones. |
| never beenshown to improve survival. | | | | |
| | | | Make a list of all symptoms and medication |
| But in May 2004, the U.S. Food and Drug | | | | side effects you are experiencing. |
| Administration (FDA) approved a chemotherapy | | | | |
| drug called Taxotere (docetaxel) for use in | | | | Prepare a list of your questions and |
| combination with the steroid prednisone, for | | | | concerns. |
| the treatment of advanced prostate cancer | | | | |
| that is not responding to hormone therapy. | | | | Find out what clinical trials might be |
| This new combination can help some | | | | available to you. |
| patientslive longer with the disease. | | | | |
| | | | Consider your expectations for participating |
| A study of more than 1,000 men with advanced | | | | in a clinical trial. |
| hormone-refractory prostate cancer | | | | |
| demonstrated that giving an injection of | | | | Consider the advantages and disadvantages of |
| Taxotere in combination with prednisone every | | | | being in a clinical trial. |
| three weeks demonstrated a survival | | | | |