ADT (ANDROGEN-DEPRIVATION THERAPY)
Because male hormones, such as testosterone (a type of androgen), help prostate cancer grow, this type of therapy works to lower those hormone levels. ADT is used to treat prostate cancer that has returned after surgery and radiation therapy or cancer that has spread to other parts of the body. However, ADT does not cure prostate cancer and eventually stops controlling the cancer. Non-surgical ADT therapies are either injected or taken by mouth.
Surgery called an orchiectomy is used to remove both testicles to stop the production of testosterone. When the testicles are removed, the cancer tends to stop growing or shrinks for a period of time. It’s a permanent procedure, as the testicles cannot be re-inserted, but also tends to be one of the less expensive androgen-reducing treatment options.
Prostatectomy is a surgical procedure performed at any stage of the disease, that removes all or part of the prostate and seminal vesicles. Sometimes cancer begins in, or spreads to, the lymph nodes. Lymph nodes exist in many places in the body and may need to be removed from the pelvic area during a prostatectomy. This procedure can happen at any stage of the disease. The goal is to reduce the risk of the cancer from spreading to other parts of the body. This procedure may cause sexual problems, because nerves can be damaged during the process. Efforts can be taken to resume normal function. You may have difficulty controlling your urine.
Hormonal therapy works to reduce the effects of androgen when your regular antiandrogen therapies have stopped working. This type of therapy can block an enzyme that stops the testicles and other parts of the body from making testosterone. Hormonal therapy can be taken by mouth.
There are two different types of radiopharmaceuticals—alpha-emitting and beta-emitting. These treatments are designed to treat cancer that has spread to the bone. After being injected into a vein (intravenously or IV), the medicine travels throughout the body, and settles predominantly in areas of bone that have been affected by cancer. The radiation kills cancer cells. Unlike external beam radiation therapy (EBRT), a type of radiation that focuses on one area at a time, this treatment can treat many bones affected by cancer at the same time.
Chemotherapy may be used when prostate cancer has spread outside of the prostate gland and hormone therapy isn’t working. Its goal is to destroy cancer cells by stopping them from growing or dividing into more cancer cells. Because chemotherapy targets cells that divide quickly, it can affect fast-growing cells in the:
- Bone marrow
- Lining of the mouth and intestines
- Hair follicles
Chemotherapy is injected into a vein intravenously or taken by mouth. It’s delivered through the bloodstream to reach cancer cells all over the body. This type of treatment can lead to side effects.
Immunotherapy uses a person’s own immune system to fight cancer. The immune system is made up of cells like the ones in your blood. The immune system cells travel through your body to protect it from germs that cause infections. These cells can be used to fight and kill cancer cells.
Radiation uses x-ray beams or small radioactive pellets also known as “seeds” placed (implanted) inside the prostate. These kill cancer cells by destroying the part responsible for controlling how cells grow and divide.
Radiation therapy can be used to:
- Treat low-grade cancer only in the prostate
- Treat cancer that has grown outside of the prostate gland and into nearby tissues
- Treat cancer that is not completely removed or returns to the area of the prostate after surgery
- Reduce the size of the tumor if the cancer is advanced
External beam radiation therapy (EBRT), a type of radiation, provides relief from the most painful symptoms of bone metastases.
Cancer can break down the bone. Bisphosphonates are used to protect the bone from these damaging effects. Bisphosphonates may also increase bone mass density. This lowers the chance of a serious bone incident such as a fracture. Bisphosphonates are given through the vein intravenously (IV) or by injection.
There is another type of supportive care called beta-emitting radiopharmaceuticals. They are focused only on relieving bone pain.