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Prostate Cancer (cont.)


Chemotherapy is the also used against prostate cancer.

  • The utility of chemotherapy in the management of metastatic prostate cancer continues as an area of ongoing research.
  • This therapeutic option has been explored most in patients with hormone-resistant disease.

Newer chemotherapy medicines, such as docetaxel (Taxotere), have shown some promise in prolonging the survival of some patients with extensive prostate cancer. They may also decrease the pain related to widespread cancer. However, this comes at the cost of significant side effects that may impact quality of life.

Symptom palliation: The primary approach to the management of symptoms in patients with advanced prostate cancer is systemic therapy with both older and newer forms of hormomal treatments, then chemotherapy. Today immunotherapy and radioactive isotope treatments may be used. Radiation to painful bone lesions may be used. Throughout all of this, optimal pain medicine use and other therapies for cancer-related symptoms should be administered. For patients with castrate-resistant prostate cancer, palliative therapy may be indicated to treat symptomatic bone metastases or symptoms arising from progressive disease.

Prostate Cancer Follow-up

Follow-up care is especially important for patients who opted for a more conservative approach (such as watchful waiting) to treat prostate cancer. It is imperative that a man see his urologist for digital rectal exams, PSA level tests, and other tests as recommended to follow the progression of cancer growth.

For men who have undergone radical prostatectomy, radiation therapy, or both, follow-up care is important to prevent cancer recurrence.

  • PSA has been shown to be useful in detecting recurrences. PSA levels should be less than 0.2 ng/mL after radical prostatectomy.
  • PSA levels should be checked every 3 months for 1 year, every 6 months for the second year, and annually after that.
  • A man should have a physical examination, including digital rectal exam, every 3 months for 1 year, then every 6 months for a year, then yearly after that.
  • In certain cases after radical prostatectomy, additional treatment may be required based on the final pathology report of the removed prostate or if the PSA starts increasing after surgery.
  • This may be in the form of additional radiation treatment to the area where the prostate once was and/or hormonal treatment with LHRH agonists or antiandrogens as mentioned earlier.
Medically Reviewed by a Doctor on 3/31/2015

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