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Prostate Cancer: Treating Cancer That Has Spread

Cancer that has spread beyond the prostate (stage IV) can often be treated. Treatment might include 1 or more of these:

  • Hormone therapy

  • Chemotherapy

  • Radiation therapy

  • Surgery

  • Vaccine therapy

  • Medicines for cancer in the bones

  • Medicines for pain control

  • Clinical trial

Hormone therapy

Man talking a pill with large glass of water.

Hormone therapy can slow the growth and spread of the cancer. Testosterone and other male hormones can cause prostate cancer to grow. Hormone treatments can include:

  • Anti-androgens. These medicines keep the cancer cells from using testosterone. They are given as pills.

  • CYP17 inhibitors. These medicines slow the amount of hormones made in prostate cancer cells and other body cells. They're given as pills.

  • Luteinizing hormone-releasing hormone (LHRH) agonists or antagonists.  These medicines reduce the amount of testosterone made by the testicles. They're given as shots (injections).

  • Orchiectomy. This surgery removes the testicles. The testicles are the main source of testosterone.


Chemotherapy (chemo) may help ease symptoms and control the cancer. Chemo medicines destroy cancer cells anywhere in the body. Chemo for prostate cancer is given through an IV (into a vein). It might be used along with hormone therapy. Or, it may be used if hormone therapy is no longer working. It may help slow the growth of cancer and help men live longer. By shrinking the tumor, it can help relieve pain and other symptoms.

Radiation therapy

Radiation may be used to treat symptoms and control the cancer for as long as possible. For instance, by shrinking a tumor, it may ease pain, bleeding, or trouble passing urine, or other symptoms.


A surgery called transurethral resection of the prostate (TURP) might be used to control problems passing urine. A long, thin surgery tool called a resectoscope is put in through the penis to remove the prostate tissue that's blocking the urethra. This is the tube that goes from the bladder through the penis so urine can come out of the body.

Vaccine therapy

A prostate cancer vaccine may be an option for some men whose advanced cancer has stopped responding to hormone therapy, but is not causing major problems. The vaccine does not cure the cancer, but it may help men live longer.

Medicines for cancer in the bones

Medicines can help slow or treat the spread of cancer to the bones. If prostate cancer spreads, it often goes to the bones first. This can cause pain and other symptoms. Different types of medicines can be used to help slow the cancer growth and help relieve symptoms. Some of the medicines that can be used contain radiation.

Medicines for pain control

Cancer pain can be managed with medicines. Prostate cancer that has spread may cause pain. This pain can be treated. Many of the treatments above can help relieve cancer pain. Pain medicines can also help. Controlling pain can improve your quality of life. It can help ease stress and help you to better fight the cancer. Talk to your provider if you have pain. Also talk about the side effects of pain medicines and what you can do about them.

Clinical trials

Most experts agree that treatment in a clinical trial is a good option for advanced prostate cancer. This way men can get the best treatment available now and may also get the treatments that are thought to be even better. Most of the new and promising treatments are only available in clinical trials. Your healthcare provider can talk with you about whether a clinical trial might be a good option for you.

Online Medical Reviewer: Kimberly Stump-Sutliff RN MSN AOCNS
Online Medical Reviewer: Lu Cunningham RN BSN
Online Medical Reviewer: Richard LoCicero MD
Date Last Reviewed: 12/1/2019
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