Treatment by stage

Discussion entre un urologue et un homme sur les traitements du cancer de la prostate

Overview

cellule cancer prostateAfter receiving your diagnosis for prostate cancer, it is natural to imagine the worst and worry about how cancer will affect your life and the lives of your loved ones. It can be difficult and stressful to have to decide on your treatment. You will most certainly have questions regarding your prognosis and may want to know what the chances are for a successful treatment.

Unfortunately, no one can tell you exactly what your outlook will be since many factors come into play: your type of prostate cancer (grade, stage, PSA rate), your age, your health status, your medical and family history, among others. Here is a summary of the types of prostate cancer.

Localized prostate cancer

  • In most cases, this cancer is slow-growing and does not affect your lifespan.
  • In many cases, the primary treatment will get rid of the cancer.
  • In some cases, the cancer can be aggressive, evolve more quickly and spread elsewhere in the body
  • In some cases, the cancer recurs after the primary treatment and other treatments become necessary.

Locally advanced prostate cancer

  • In many cases, the primary treatment aims to eliminate the cancer.
  • Treatment may involve a combination of therapeutic approaches.
  • In some cases, the cancer recurs after the primary treatment and other treatments become necessary.

Metastatic prostate cancer

  • This cancer cannot be cured.
  • Hormone therapy can be effective in keeping your cancer under control for many years.
  • Developing a resistance to hormone therapy calls for further treatments.
  • Chemotherapy can be effective in keeping your cancer under control for many years.
  • Treatments can also relieve pain and symptoms related to metastases

Stage 1 and 2

Localized prostate cancer

The cancer is localized only within the prostate. The important thing here is to determine the risk of cancer progression (see Prognosis and Survival). When it comes to localized prostate cancer, your treatment options are:

  1. Active surveillance
  2. Radical prostatectomy (surgery) with or without pelvic lymph node dissection
  3. Radiation therapy (external or brachytherapy) with or without short/medium/long term hormone therapy

Stage 3

Locally advanced prostate cancer

The cancer has begun to break out of the prostate, but not too far. When it comes to locally advanced prostate cancer, your treatment options are:

  1. Radical surgery and pelvic lymph node dissection
  2. Radical surgery with adjuvant pelvic radiotherapy (after surgery)
  3. External radiotherapy combined with hormone therapy
  4. External radiotherapy combined with temporary brachytherapy

Stage 4

Metastatic prostate cancer

The tumour has spread to neighbouring organs, lymph nodes, or other parts of your body far from your prostate. When it comes to metastatic prostate cancer, your treatment options are:

  1. Hormone therapy
    • first generation
    • bilateral orchiectomy (removal of the testicles)
    • second generation
  2. Chemotherapy

Recurrent

With or without metastasis

A recurrent cancer corresponds to a cancer that returns after radical prostatectomy or radiotherapy. Recurrence can be biochemical only (increase of prostate specific antigen (PSA) in the blood) or clinical (appearance of metastases on imaging tests). When it comes to a recurrence, your treatment options are:

  1. Monitoring only (if the biochemical recurrence is slow)
  2. Hormone Therapy – Medical or Surgical
  3. Chemotherapy when you no longer responds to hormone therapy

Case studies

Drugs used

Treatments can be given to cure cancer or to control or relieve symptoms. You may receive a single treatment or a combination of treatments based on your individual preferences / values and depending on the grade and stage of your cancer (i.e. how far the cancer has spread and how fast it can grow).

This section provides you with information on drugs to treat prostate cancer that are currently approved by Health Canada. As new prostate cancer drugs are approved for use in Canada we will update our information in a timely manner.

Approuved by Health Canada

Drugs used in chemotherapy and radiotherapy

Drugs used in hormone therapy

The most common LHRH agonists are:

The LHRH antagonist is:

The most common types of anti-androgens are:

Second line hormone therapy (new generation)

  • Acétate d’abiratérone (Zytiga)
  • Apalutamide (Erleada)
  • Enzalutamide (Xtandi)
  • Darolutamide (soon available)

Drugs to treat bone metastases symptoms 

For more information on medications reimbursed in Quebec, please visit the National Institute of Excellence for Health and Social Services (INESSS) website.

We are here for you

You have questions or concerns? Don’t hesitate. Contact us at 1 855 899-2872 to discuss with one of our nurses specialized in uro-oncology. They are there to listen, support and answer your questions, those of your family or your loved ones. It’s simple and free, like all of our other services.

Also take the time to visit each of our pages on this website, as well as our YouTube channel, in order to get familiar with the disease, our expert lectures and webinars, our section on available resources, the support that is offered to you, our events and ways to get involve to advance the cause.

Staying informed

Pages that might interest you
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The medical content and editorial team at PROCURE
Our team is composed of urologists, nurses certified in uro-oncology with a deep knowledge of prostate cancer and other diseases related to the genitourinary system. Meet our staff by clicking here.

Sources and references

Last medical and editorial review: July 2019
Written by PROCURE. © All rights reserved – 2019bandeau ligne 1 855 pour cancer prostate

 

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