We haven’t looked at the research on treatments for advanced prostate cancer in the same way as we have for other treatments on our site. We plan to do this in the future

There are two forms of advanced prostate cancer, locally advanced prostate cancer and metastatic prostate cancer. Most of the treatments are similar to those used on early prostate cancer, but there are some differences.

Locally advanced prostate cancer

Locally advanced prostate cancer includes cancer that has just spread from the prostate itself to the surrounding ‘capsule’ tissue, to cancers that have spread to nearby organs like the bladder or rectum or the lymph nodes. But the cancer has not spread to tissues further away from the prostate.

Radiotherapy

Radiotherapy may be used to treat locally advanced prostate cancer. A type called conformal radiotherapy is becoming more common in which the beam of radiation is carefully shaped to match the shape of the cancer, and to limit damage to surrounding healthy cells.

Where there is some risk of spread to the lymph nodes near the prostate, another type of radiotherapy, pelvic radiotherapy, may also be used. Radiotherapy is usually used with hormone therapy.

Hormone therapy

Men who are receiving radiotherapy often also usually have hormone therapy. If the cancer is likely to be aggressive (it has a high Gleason score) hormone treatment may continue for several years.

Other treatments

High intenstity focused ultrasound (HIFU) is a new treatment in which ultrasound waves are directed at the prostate tumour from a probe inserted into the rectum. The ultrasound waves cause cancer cells to heat up and die. But it is not clear how well it works and what the side effects are so it remains an experimental treatment.

Cryotherapy: this treatment uses freezing cold probes to kill cancer cells. Its long-term benefits and side effects are unknown.

Advanced (metastatic) prostate cancer

When cancer has spread from the prostate and the tissues around it to more distanct tissues and organs, it is known as advanced or metastatic prostate cancer.

Hormone therapy

Long-term hormone therapy is used to reduce the size of the tumour, slow down the growth and spread of the prostate cancer cells and reduce symptoms. There is a range of side effects, which vary between the different hormone treatments. Additional treatments may be needed to manage the side effects of hormone therapy.

Surgery

Surgery to remove the hormone-producing part of the testicles, or the entire testicles (an operation called orchidectomy), stops most production of androgen hormones. These are the hormones that prostate cancer cells need to grow and spread. The effect of this surgery is similar to long-term hormone therapy.

Drug treatment (chemotherapy)

Docetaxel: treatment with this drug, also used in ovarian and testicular cancer, may be used for some men when prostate cancer cells grow despite hormone treatment.

Bisphosphonates: these drugs may be used to relieve pain in men where the cancer has spread to the bone.

Strontium-89: may be used for men with hormone refractory prostate cancer and painful bone metastases.

Palliative care

When, in advanced disease, the cancer is not responding to treatment, treatment will aim to treat symptoms such as pain.