Treating High-Risk or Recurrent Prostate Cancer
For nearly 80 percent of men with prostate cancer, doctors diagnose the disease early, in the local or regional stages. Doctors expect most of these men will be cured with radiation or surgery. However, one in five men with prostate cancer is diagnosed with high-risk disease—which has a tendency to spread even though, by all clinical appearances, it is localized. Despite having been treated for prostate cancer, about 30 to 40 percent of men suffer a relapse, meaning their cancer returns. Among these men, fewer than 50 percent are cured. Men with recurrent disease account for most of the 27,000 prostate cancer deaths in the United States each year.
The only therapy that has been adequately tested in clinical studies to treat prostate cancers that might have spread is hormone therapy. It is commonly used in combination with radiation therapy or after surgery (prostatectomy) for men with metastasis to lymph nodes. Hormone therapy is also used to treat cancers that weren’t cured with either radiation or surgery. Hormone therapy lowers serum testosterone, depriving prostate cancer cells of a growth factor critical for their survival.
Seattle Cancer Care Alliance is at the forefront of developing new treatment strategies designed to improve results in men with high-risk prostate cancer. These approaches involve treating both the cancer in the prostate and any cancer that might have spread. A new generation of systemic therapies is showing clinical promise when combined with surgery or radiation therapy.
Various tools can help predict the efficacy of surgery or radiation therapy for prostate cancer. This can help patients and doctors make treatment decisions.
Getting input from an experienced team of leading prostate cancer specialists is the best way to design the optimal treatment approach for high-risk disease. Surgery, radiation therapy, or in some cases a combination of surgery and radiation may be recommended.
To improve outcomes, high-risk prostate cancer requires systemic therapy, such as hormone therapy and chemotherapy, to combat cells that might have spread prior to diagnosis and therapy.