Treatment options for Metastatic Prostate Cancer:
Metastatic prostate cancer refers to cancer that originated in the prostate and has spread to other regions of the body, often termed advanced prostate cancer.
In cases where prostate cancer is advanced, it typically indicates that it is beyond cure. However, treatments are available that can alleviate symptoms, improve quality of life, and extend lifespan. Many men with advanced prostate cancer continue to live a normal life for several years.
The testicles
The testicles are two small, oval-shaped organs located below the penis, enclosed in a skin pouch called the scrotum.
Image of the testicles (cruk)
Starting from puberty, the testicles begin producing sperm. Inside the testicle, small tubes come together to form the epididymis, a single tube that becomes wider as it exits the testicle. This wider tube is known as the spermatic cord.
The spermatic cord leads to a short passage called the ejaculatory duct, which opens into the urethra, the tube that carries urine and semen out of the body through the penis.
Testosterone:
The testicles produce the hormone testosterone, which is responsible for developing male characteristics such as:- A deeper voice
- Facial hair growth
- Increased muscle mass
- The ability to achieve an erection
- Male sexual drive (libido)
Where does testicular cancer start:
The testicles consist of various cell types, and the kind of cancer you have depends on the specific cell where it begins. Most testicular cancers arise from germ cells, which are responsible for producing sperm. Doctors classify germ cell cancers into two main types:- Seminoma
- Non-seminoma
5.1:Deciding which treatment you need:
A team of doctors and other healthcare professionals, known as a Joint Committee(JC), will recommend the most suitable treatment and care for you. This team may consist of:
– A medical oncologist or cancer specialist
– A specialist nurse or clinical nurse specialist (CNS)
– A doctor specializing in symptom control or palliative care
Your team will review your scans and test results and suggest the best treatment options for you, explaining both the benefits and potential side effects.
Your treatment plan will be based on:
– The location of your cancer and the areas it has spread to
– Your overall health and fitness level
– Your PSA blood test results
– The symptoms you are experiencing
– Any prior treatments you have received
5.2:Treatment Overview:
Choosing the most suitable treatment can be challenging. Your doctor will go over the various options and assist you in making an informed decision. Typically, you will receive a combination of these treatments:
– Hormone therapy
– Chemotherapy
– Radiotherapy
– Targeted cancer drugs
– Symptom management, such as treatments for bone pain
You might not begin treatment immediately. Instead, your doctor may suggest closely monitoring your cancer and starting treatment only if side effects develop.
5.3: First Treatment for metastatic prostate cancer:
The initial treatment you typically receive is hormone therapy, combined with:
– Additional hormone therapies like apalutamide or enzalutamide, or
– Chemotherapy
Prostate cancer generally relies on the hormone testosterone for growth. Hormone therapy works by blocking or reducing the body’s testosterone levels. Common hormone therapy injections include goserelin and degarelix.
Chemotherapy is a treatment that uses anti-cancer drugs to kill prostate cancer cells. These drugs travel through the bloodstream, reaching cancer cells throughout the body. The most frequently used chemotherapy drug for prostate cancer is docetaxel.
5.4:Treatment for Metastatic castration resistant prostate cancer:
A combination of various hormone therapies or hormone therapy with chemotherapy can often manage metastatic prostate cancer for many months or even years. However, sometimes the cancer may begin to progress again after the initial treatment.
You might hear your doctor refer to this as:
– Castration-resistant prostate cancer, or
– Hormone-refractory prostate cancer
This indicates that hormone therapy is no longer effective. In such cases, your doctor might suggest:
– A different type of hormone therapy combined with chemotherapy
– An additional hormone therapy drug
– Chemotherapy with steroids
– Bisphosphonates
– Radiotherapy
– Radioisotope therapy such as Radium-223 or Lutetium-177-PSMA
Your doctor may also recommend a targeted drug called Olaparib if you have a mutation in the BRCA1 or BRCA2 genes.
5.5: Treatment for metastatic hormone sensitive prostate cancer:
Hormone-sensitive metastatic prostate cancer indicates that the cancer has spread to other areas of the body but can still be managed with hormone therapy. Your doctor may suggest the following treatment options:
– Hormone therapy combined with chemotherapy
– Hormone therapy on its own
– A combination of various hormone therapy medications
Daignosis
If you have any symptoms, your first step is usually to visit your GP. They will discuss your symptoms with you and conduct an examination. Based on their findings,
Treatment options
A team of healthcare professionals (multidisciplinary team) will determine your treatment plan. Most people undergo surgery to remove the affected