Advanced Prostate Cancer Treatments

Advanced Prostate Cancer is cancer that has spread, or metastasized, beyond the prostate. This is also known as metastatic prostate cancer. There are more treatment options available than ever before with many other systemic therapies under development.  

Chesapeake Urology's prostate cancer specialists work closely with you to guide you through the best therapies and treatment options available including:  

  • Hormone therapy is used when prostate cancer has spread to other parts of the body, or returned after treatment. It can also be used temporarily during radiation therapy for six months to two years to improve localized cancers. The goal of hormone therapy is to eliminate the testosterone produced by the testicles that causes the cancer to grow. There are two categories of hormone treatments:
    1. Medical therapy- used to stop the production of testosterone by the testicles and other androgens from the adrenal glands.
    2. Surgical therapy - known as bilateral orchiectomy, both testicles, the main sources of androgen production, are removed. 
  • Immunotherapy (Biologic Approaches) may be used for men with advanced prostate cancer who are not helped by hormone therapy. Immunotherapy, including therapeutic vaccines and other biologic approaches, harness the immune system to selectively target cancer cells. 

    - Sipuleucel-T (PROVENGE®)
    is an innovative treatment option for certain men with advanced prostate cancer that uses the body's own immune system to fight the cancer. Each dose consists of the patient's own immune cells that have been trained to seek and attach to the prostate cancer cells.  The Provenge treatment is given in our Infusion Therapy Center

  • Radiotherapy is a treatment that involves the use of high-energy radiation to treat cancer. Radiotherapy is used alone or in combination with chemotherapy to treat cancers. 

    - Radium Ra 223 Dichloride (Xofigo®)
    is used to treat prostate cancer that is resistent to medical or surgical treatments that lower testosterone and has spread to the bones, but not to other parts of the body. 

  • Medications Used to Improve Bone Health - Metastatic prostate cancer commonly spreads to the bones where it can cause bone pain and brittle-bone disease (osteoporosis). These symptoms can also arise during hormone therapy. Your physician may prescribe medications that can reduce bone loss that may result from hormone therapy, reduce the spread of cancer in the bone, alleviate pain and minimize other complications of bone metastases. 

    - Denosumab (Xgeva®) - 
    Xgeva is  used for prostate cancer patients with metastatic bone disease to prevent fractures, severe bone pain and spinal cord compression. 

    - Denosumab (Prolia®) - Prolia is used to increase bone mass in men wih non-metastatic prostate cancer who are receiving hormonal therapy and are at high risk for fracture. 

    - Zoledronic Acid (Zometa®) - Zometa is a treatment that can help reduce and delay bone complications such as skeletal fractures caused by cancer that has spread to the bone. 


  • Chemotherapy is the delivery of powerful drugs intravenously, orally or in combination, to kill cancer cells. It is typically not used as an initial therapy because the drugs are not as effective as hormone therapy. However, after hormone therapy becomes less effective, various chemotherapy drugs may improve symptoms, reduce PSA levels and/or decrease prostate cancer cells. 

    - Abiraterone Acetate (ZYTIGA®) is an oral medication that is used with prednisone to treat men with castrate-resistant prostate cancer.

    - Enzalutamide (XTANDI®) is a medication that is used to treat men with castrate-resistant prostate cancer (prostate cancer that is resistant to medical or surgical treatments that lower testosterone) that has spread to other parts of the body and who have received treatment with docetaxel.

    - Docetaxel (Taxotere®) is an injection used alone or in combination with other medications to treat certain types of breast, lung, prostate, stomach and head and neck cancers. The injection is in a class of medications called Taxanes. It works by stopping the growth or spread of cancer cells. 

    - Cabazitaxel (Jevtana®) is a prescription anti-cancer medication used with the steroid prednisone. It is used to treat men with advanced prostate cancer that has progressed after treatment with other anti-cancer medications. 

    - Mitoxantrone is used to treat leukemia and prostate cancer, as well as other conditions. It works by stopping the growth of cancer cells, which are then destroyed. 


  • Clinical Trials - Clinical trials can offer state-of-the-art treatments to patients before becoming FDA standard treatments. Chesapeake Urology has a number of clinical trials for men with advanced prostate cancer.  For details on clinical trials offered by Chesapeake Urology Research Associates, including eligibility and contact information, view our listing of current clinical trials. 

Learn more about any of the above listed therapies for advanced prostate cancer - visit the Chesapeake Urology Prostate Cancer website.