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