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