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