Systemic Therapy for Prostate Cancer

Systemic therapies are medicines. The patient can receive them in IV infusions or injections or take them as pills. They are generally used in later-stage or metastatic prostate cancer.

Given the rapidly-evolving landscape of treatment for advanced prostate cancer, you are in the best hands at Siteman, where the doctors are knowledgeable about the latest developments in systemic therapy and actively investigating future advances. For patients who have failed standard therapy and are looking for experimental approaches, Siteman offers a range of clinical trials.

There are three main types of systemic therapy for prostate cancer:

  • Hormone therapy
  • Chemotherapy
  • Immunotherapy

What is hormone therapy for prostate cancer?

Prostate cancer is driven by androgens, which are the male sex hormones testosterone and dihydrotestosterone. Hormone therapy prevents prostate cancer cells from obtaining androgens, either by limiting the production of androgens in the body or making it impossible for the androgens to attach to the cancer cells. This slows or halts the progression of prostate cancer.

For patients who have metastatic prostate cancer, or whose prostate cancer has come back after surgery and/or radiation, hormone therapy is the standard of care.

Hormone therapies may be given in different combinations, depending on the stage of the cancer and the health of the patient. New combinations of therapies are always being tested in clinical trials and may be available at Siteman before many other treatment facilities have access to them.

Hormone therapy can be taken in pill form or received as injections. Patients tend to tolerate it well, but there are some side effects, such as mood swings and hot flashes, that have been compared to a “male menopause.” If necessary, your physician can prescribe you an additional medication to relieve these symptoms.

What is chemotherapy for prostate cancer?

Chemotherapy is seldom used in the treatment of prostate cancer. Only two drugs are approved to treat it, which may be recommended in patients with advanced disease.

What is immunotherapy for prostate cancer?

Immunotherapy uses the body’s immune system to destroy prostate cancer cells. It has revolutionized cancer care owing to its success in treating patients with advanced cancers who have failed conventional chemotherapy.  For prostate cancer, only one approved immunotherapy exists (e.g. Provenge®), and it is used for patients who have very advanced disease.

Urologists at Siteman Cancer Center, however, are collaborating with multidisciplinary team of medical oncologists, radiation oncologists, radiologists, and pathologists to explore the role of immunotherapy earlier in prostate cancer.  We have active clinical trials using immunotherapy for patients with low-risk disease on active surveillance, as well as immunotherapy for patients otherwise eligible for a prostatectomy, with the goal in both cases to cure patients of their disease.  As the role of immunotherapy in prostate cancer continues to expand, it is important to seek care for your prostate cancer at a center that has the newest treatment options available.