Medical Author: John P. Cunha, DO, FACOEP
Medically Reviewed on 9/10/2021
Doctor's Notes on Prostate Cancer
Prostate cancer is a disease in which cells in the prostate gland, a part of the male reproductive system, start to multiply uncontrollably. Prostate cancer cells can also spread (metastasize) to other organs and tissues in the body, commonly the pelvic lymph nodes and bones. Less commonly prostate cancer cells may also metastasize to the lungs and liver.
Most men will have no symptoms of prostate cancer, especially in the early stages. When they do occur, symptoms of prostate cancer are typically due to urinary blockage at the bladder neck or the urethra and may include difficulty in starting and stopping urination, increase in frequency of urination, pain while urinating, urinary retention, and a feeling of bladder fullness after urination. When the blockage is chronic, recurring urinary tract infections (UTIs) may occur.
Rare symptoms of advanced prostate cancer may include
- blood in the urine,
- painful ejaculation, and
- impotence.
If prostate cancer has spread, symptoms may include
- fatigue,
- feeling unwell (malaise), and
- weight loss.
- Metastasis to the bones can cause deep bone pain.
What Is the Treatment for Prostate Cancer?
Treatment for prostate cancer depends on whether cancer is in part or all of the prostate, if it has spread (metastasized) to other parts of the body, and the age and overall health of the patient, and may include one or more of the following:
- Watchful waiting (active surveillance)
- Surgery: removal of the whole prostate and some nearby tissue
- Radiation therapy
- External beam radiation
- Brachytherapy (internal radiation)
- Cryotherapy (also called cryosurgery or cryoablation)
- Uses very cold temperatures to freeze and kill prostate cancer cells as well as most of the prostate
- Hormone therapy
- Androgen deprivation therapy (ADT) uses surgery or medicines to lower the levels of androgens made in the testicles
- Orchiectomy (surgical castration)
- Luteinizing hormone-releasing hormone (LHRH) agonists (also called LHRH analogs or GnRH agonists) are drugs that lower the amount of testosterone made by the testicles (also called medical castration)
- Leuprolide (Lupron, Eligard)
- Goserelin (Zoladex)
- Triptorelin (Trelstar)
- Histrelin (Vantas)
- LHRH antagonists
- Degarelix (Firmagon)
- Relugolix (Orgovyx)
- Chemotherapy
- Docetaxel (Taxotere)
- Cabazitaxel (Jevtana)
- Mitoxantrone (Novantrone)
- Estramustine (Emcyt)
- Immunotherapy
- Cancer vaccine Sipuleucel-T (Provenge)
- Immune checkpoint inhibitors
- PD-1 inhibitor pembrolizumab (Keytruda)
- Targeted therapy
- PARP (poly(ADP)-ribose polymerase) inhibitors
- Rucaparib (Rubraca)
- Olaparib (Lynparza)
- PARP (poly(ADP)-ribose polymerase) inhibitors
- Treatments for prostate cancer spread to bones
- Bisphosphonates: zoledronic acid (Zometa)
- Denosumab (Xgeva)
- Corticosteroids
- External radiation therapy
- Radiopharmaceuticals
- Strontium-89 (Metastron)
- Samarium-153 (Quadramet)
- Radium-223 (Xofigo)
- Surgery
- Kyphoplasty: surgery to stabilize a painful collapsed bone in a spine weakened by prostate cancer
- Pain medicines
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How Long Can You Live Without Prostate Cancer Treatment?
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Inability to Urinate
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What Is the Best Test to Diagnose Prostate Cancer?
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What Is the Life Expectancy of Someone with Stage 4 Prostate Cancer?
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What Is the Life Expectancy When Prostate Cancer Spreads to Bones?
Life expectancy for prostate cancer is usually given as five-year survival rates, or the percentage of people who will be alive five years after diagnosis. In stage 4 prostate cancer, when the cancer has spread to other organs, the survival rate is below 30%. -
What Is the Main Cause of Prostate Cancer?
Prostate cancer is cancer developing in the prostate gland in men. It is one of the most common types of cancer seen in men older than 50 years of age. The prostate is a small walnut-shaped gland in men that produces seminal fluid required to nourish and transport the sperm.
REFERENCE:
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.