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Treating Advanced Prostate Cancer

UC San Diego Health’s team of urologic cancer specialists offer men with metastatic prostate cancer the most innovative, knowledgeable and compassionate care in the region.

Our urologic cancer specialists are at the forefront of new treatments for urologic cancers and have expertise in state-of-the art approaches for slowing the progression of advanced prostate cancer and controlling its symptoms. Our expertise and whole-person approach to care can help men with advanced prostate cancer live better and longer lives.

Radiation and Surgery (Locally Targeted Therapies)

Treating advanced prostate cancer involves locally targeted and systemic therapies. Locally directed therapies are used to kill and remove cancer in the prostate, and include:

Locally targeted therapies can be highly effective for tumors that are completely contained within the prostate. For tumors that have spread beyond the prostate, systemic therapy may be recommended.

Hormone Therapy and Other Systemic Therapies

Systemic therapies refer to drugs that move throughout the body to fight cancer, wherever the cancer may be. The first-line systemic therapy for many men is hormone therapy, also known as anti-androgen, androgen ablation or androgen-deprivation therapy.

Why Is Hormone Therapy Used to Treat Prostate Cancer?

Male hormones (androgens) fuel the growth of many types of prostate cancer. Hormonal agents suppress cancer proliferation by counteracting the cancer-promoting effects of androgens. Hormonal agents for prostate cancer include:

  • Luteinizing hormone-releasing (LHRH) agonists and antagonists, which block the production or activity of androgens
  • CYP17 inhibitors, which inhibit an enzyme involved in the synthesis of androgens
  • Androgen receptor (AR) inhibitors, which prevent androgen receptors from binding with androgens

When Is Chemotherapy a Treatment for Prostate Cancer?

Advanced prostate cancer can become hormone-refractory or androgen-independent, which means that the cancer is no longer responsive to the anti-androgen effects of hormonal agents. Chemotherapy may be used to kill cancer cells directly when this occurs. Docetaxel, which is given intravenously in combination with the steroid prednisone, is a first-line chemotherapy in for hormone-refractory prostate cancer. If the cancer continues to spread after treatment with docetazel, another chemotherapeutic agent, known as cabazitaxel, may be administered.

If the cancer spreads to the bones, a radiopharmaceutical known as radium-223 dichloride may be used to target bone metastases. The radium emits low levels of radiation that kill cells.

Are There Personalized Medicines for Advanced Prostate Cancer?

Yes. We offer a personalized vaccine therapy for advanced prostate cancer, called sipuleucel-T, which harnesses the body's own immune system to attack cancer cells in the body. 

Though our Center for Personalized Cancer Therapy, we also provide genetic testing and molecular analyses that can tailor a treatment plan that is best for you. 

Clinical Trials for Advanced Prostate Cancer

UC San Diego Health offers men early access to the most promising new prostate cancer treatments through participation in a clinical trial. Access to clinical trials is one of the many advantages of receiving care at UC San Diego Health.