Systemic Therapy for Prostate Cancer

Systemic therapies are medicines that cancer patients can receive as IV infusions, injections or pills. In general, systemic therapy for prostate cancer treats later-stage or metastatic disease.

Given the rapidly evolving landscape of treatment for advanced prostate cancer, you are in expert hands at Siteman. Our Washington University prostate cancer specialists are knowledgeable about the latest developments in systemic therapy. They are also are actively investigating future advances through research studies. For patients looking for experimental approaches when standard therapy hasn’t been successful, 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 growth depends on 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 or making it impossible for 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.

Prostate cancer patients may receive hormone therapy in pill form or as injections. Most tolerate it well, but there are some side effects, such as mood swings and hot flashes that have been called “male menopause.” If necessary, your physician can prescribe an additional medication to relieve these symptoms.

What is chemotherapy for prostate cancer?

Chemotherapy isn’t a common treatment for 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. Thanks to its successful treatment of patients with advanced cancers who have failed conventional chemotherapy, immunotherapy has revolutionized cancer care.  For prostate cancer, only one approved immunotherapy exists (e.g. Provenge®) for the treatment of patients with very advanced disease.

Washington University urologists at Siteman, however, are a part of a multidisciplinary team of medical oncologists, radiation oncologists, radiologists and pathologists exploring 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. The goal in both of these cases is to cure patients of their disease.  As the role of immunotherapy in treating 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.