Prostate cancer is cancer arising from the prostate gland. In late stages, typically stage III and stage IV, according to the American Cancer Society (ACS), the cancer has spread beyond the prostate gland into surrounding tissues and may have spread to the bladder, rectum, lymph nodes in the area or distant sites like the bones. Drug treatment for late prostate cancer depends on the state of health of the patient, the extent of spread and the patient's preferences. There are several drugs used in treatment of late prostate cancer.
Hormone Therapy
Prostate cancers depend on the male sex hormones, or androgens, for growth. Hormone therapy in prostate cancer seeks to remove the androgens, or their effects. According to the NCI, hormonal therapy, also known as androgen deprivation, or androgen ablation, therapy is the mainstay of treatment for advanced stage IV cancer. Drugs used in hormonal therapy include luteinizing hormone releasing hormone (LHRH); analogs like leuprolide, goserelin, triptorelin; and histrelin and LHRH antagonists like degarelix and abarelix. Antiandrogens like bicalutamide, flutamide and nilutamide; and estrogens like ethinyl estradiol, diethylstilbestrol-diphosphate and chlorotrianisene are also used in advanced prostate cancer, according to the National Cancer Institute (NCI).
Chemotherapy
Drugs that kill cancer cells or stop them from growing and spreading are used in chemotherapy for advanced prostate cancer. The ACS states that docetaxel with prednisolone is used to prolong life and relieve symptoms in advanced prostate cancer, and is being considered as the first choice of treatment in cases of prostate cancer where hormonal treatment has failed. Other drugs mentioned by the ACS for chemotherapy in prostate cancer are mitoxantrone, estramustine, doxorubicin, vinorelbine, etoposide, paclitaxel, carboplatin and vinblastine.
Other Medications
Bisphosphonates like zoledronic acid, according to the ACS, are used in advanced prostate cancer with spread to the bones, to treat bone pain and prevent fractures. They are also used to protect the bones from the bone-thinning effects of hormone therapy. Steroids like dexamethasone and prednisolone are used to treat pain in certain individuals. Opioids and other analgesics are also used in the treatment of pain in advanced prostate cancer.
References
- American Cancer Society: Prostate Cancer: Initial Treatment Options by Stage
- National Cancer Institute: Prostate Cancer Treatment: Stage IV Prostate Cancer
- American Cancer Society: Prostate Cancer Hormone (Androgen Deprivation) Therapy
- American Cancer Society: Prostate Cancer Chemotherapy
- American Cancer Society: Prostate Cancer Treatment of Pain
