Advanced Prostate Cancer Symptoms and Chemotherapy

Chemotherapy can help relieve pain and other symptoms associated with advanced prostate cancer that no longer responds to hormone therapy. Until recently, attempts to slow disease progression and improve survival with chemotherapy had proved disappointing.

But several clinical trials have now provided evidence that docetaxel (Taxotere) plus estramustine (Emcyt) or prednisone can prolong survival in men whose advanced prostate cancer no longer responds to hormone therapy. Although the survival advantage gained by using chemotherapy is modest—a few months—these landmark studies are prompting renewed research into chemotherapy's potential to affect the disease, not just ease its symptoms.

The chemotherapy drug cabazitaxel (Jevtana) is the first drug to be approved for advanced prostate cancer that continues to worsen despite treatment with Taxotere. Jevtana was approved in June 2010.

Other Treatments to Relieve Prostate Cancer Symptoms

When hormone therapy loses its effectiveness, other treatments are available to relieve cancer pain and improve quality of life. A wide range of medications—nonsteroidal anti-inflammatory drugs and corticosteroids as well as morphine and other narcotics—may be used to ease pain.

Mitoxantrone (Novantrone)—a chemotherapy drug used to treat a form of leukemia—is also approved for reducing pain from metastatic prostate cancer. Novantrone is used in combination with the corticosteroid prednisone. Using Taxotere and prednisone together can also reduce pain and improve quality of life.

Bone pain can be treated with medications known as bisphosphonates (such as zoledronic acid [Zometa]), radiation therapy, or injections of a radioactive substance called strontium-89. For a man whose prostate has not been removed, transurethral resection of the prostate (TURP) can relieve urinary tract symptoms from locally advanced disease.

Immunotherapy and Advanced Prostate Cancer

A new option for treating prostate cancer that no longer responds to hormone treatment is immunotherapy. The agent sipuleucel-T (Provenge), which was approved by the FDA in May 2010, works by targeting prostatic acid phosphatase, an antigen expressed by most prostate cancers.

In one 512-person trial, survival averaged about 26 months for men taking Provenge and 22 months for those taking a placebo.

Publication Review By: H. Ballentine Carter, M.D.

Published: 08 Jun 2011

Last Modified: 19 Feb 2015