Systemic Treatments?

This section of the PCRI Decision Aide is designed to help you locate information about the systemic treatments available for treating your prostate cancer. We hope that the subsections below will help you understand your options:

• Androgen Deprivation –discusses various primary combinations for blocking testosterone from promoting the growth of prostate cancer.
• Secondary Hormonal Treatments – discusses additional hormonal manipulations that may reverse cancer growth.
• Chemotherapy – discusses docetaxel (Taxotere®) as the primary chemotherapy for prostate cancer along with other chemotherapy drugs that might be suggested in combination with it or after docetaxel failure.
• Immunotherapy – discusses ways the body’s immune system can be facilitated to destroy cancer cells using treatments like sipuleucel-T (Provenge®).
• Other options – discusses a variety of additional treatment options including antiangiogenesis agents, bisphosphonates, spot radiation, radiopharmaceuticals and investigational agents.

Introduction

Systemic treatment options are strategies directed at destroying cancer cells in the prostate or that have metastasized to lymph nodes, bones and other organs. The treatments normally start with androgen deprivation which may be effective for a majority of men for many years. When cancer progresses on androgen deprivation, many other treatments can be considered depending on the growth pattern of the cancer and the health of the individual and his tolerance of side-effects. The last few years have provided several new options. The future appears even brighter as medical science identifies new ways to attack prostate cancer. Participation in clinical trials can allow you to gain access to new research treatments before they are widely available.

PCRI Resources:

• Testosterone Inactivating Pharmaceuticals • Mark Scholz, MD 2010
• Hormone-Refractory Prostate Cancer: A Continuum of Diseases and Options • Oliver Sartor, MD 2005
• Chemotherapy in Prostate Cancer • Richard Lam, MD 2009
• PCRI Clinical Trials page

Related Resources:

• NCCN Prostate Cancer Guidelines for Patients 2010
• Advanced Prostate Cancer and its Treatment – UCSF Patient Handout PDF Sept. 2008
• Progression of metastatic castrate-resistant prostate cancer: impact of therapeutic intervention in the post-docetaxel space J Hematol Oncol. 2011; 4: 18. Sartor AO.
• Update on options for treatment of metastatic castration-resistant prostate cancer. Onco Targets Ther. 2010; 3: 39–51. Vishnu, P and Tan, WW

Page updated 8/1/11