Fighting Metastatic Prostate Cancer

When prostate cancer has spread outside the prostate gland to affect the lymph nodes of other parts of the body, this is called metastatic prostate cancer. If you have been told that you have this disease, do not be discouraged. This is not a death sentence. There are many men that live a healthy and fulfilling life with this disease. At times, a doctor may even wait to begin treatment for metastatic prostate cancer if there are no symptoms. When treatment is necessary, there are several things one can expect.

One of the treatments for metastatic prostate cancer is ADT, or androgen deprivation therapy. When we say “androgen,” we should think of the testosterone hormone. Like breast cancer, prostate cancer is a hormone driven cancer. As a result, one of the ways to treat prostate cancer is to take away the hormone that is helping it grow. With ADT, or androgen depravation therapy, you may receive certain medications that will shut down the production of testosterone in the testicles. There are many medications; such as leuprolide and goserelin, that can accomplish this affect. Degarelix and relugolix work faster and by a different mechanism, but can accomplish the same affect. (1)

Another type of ADT, or androgen depravation therapy, is to removal the testicles. The medical term for this procedure is called an orchiectomy. This is also known as castration. There is an aversion to removal of the testicles, or castration, in the United States. Therefore, in the United States the majority of men choose to take medication to shut down the production of testosterone. (1)

When started on ADT, men can experience hot flashes and decreased sex drive, weak bones or loss of muscle mass. (2) At times, one might need to have a DEXA bone scan performed to make sure the bones are not too brittle, or have osteoporosis. (1)

There are times when prostate cancer does not respond well to castration or medications that shut down the production of testosterone. This is called castrate resistant disease. Whether one is dealing with castrate sensitive or resistant disease, the addition of chemotherapy can be beneficial. One of the options for chemotherapy includes docetaxel. This medication is used in both castrate sensitive and resistant disease as has been shown to prolong survival. (3) If someone is dealing with castrate resistant disease, another newer chemotherapy medication, such as abiraterone. (1)

Remember it is our goal to find and treat prostate cancer at an early age before this disease spreads to other parts of the body. Even with metastatic prostate cancer, there is hope and a health available to you. Many of these treatments help increase survival as you continue to enjoy time with your family and find an appreciation for all things in life. The decision for which medications are best is complex and best left to a specialist that has expertise and well as your trust and confidence. Even in this moment of battling prostate cancer, give Jesus your life and this disease. Continue to pray confidently for your health and healing. You will be surprised by the outcomes beyond what medications can do.

1. Dawson NA. Overview of systemic treatment for advanced, recurrent and metastatic castration-sensitive prostate cancer and local treatment for patients with metastatic disease. In: UpToDate, In: UpToDate, Vogelzang N, Lee RW, Richie JP (Eds), UpToDate, Waltham, MA. (Accessed on April 30, 2022.)
2. Dawson NA. Patient Education: Treatment for advanced prostate cancer (Beyond the Basics). In: UpToDate, In: UpToDate, Vogelzang N, Lee RW, Richie JP (Eds), UpToDate, Waltham, MA. (Accessed on April 30, 2022.)
3. In Alguire, P. C., & American College of Physicians, (2021). MKSAP 19: Medical knowledge self-assessment program.