The following are treatment options for recurrent prostate cancer. The types of treatments given are based on the unique needs of the person with cancer.
Hormonal therapy is the primary treatment for recurrent prostate cancer. Up to 85% of men with recurrent prostate cancer will respond to hormonal therapy. It may be offered to men who previously had surgery or radiation therapy.
The types of hormonal therapy are:
Radiation therapy may be offered for recurrent prostate cancer. The types of radiation is external beam radiation therapy:
Salvage radical prostatectomy – This may be used after radiation, HIFU (High intensity focussed ultrasound) or cryosurgerycryosurgeryA procedure that uses extreme cold (liquid nitrogen or liquid carbon dioxide) to freeze and destroy abnormal tissue. to treat a local prostate recurrence without metastasis. Incontinence and erectile dysfunction are common complications of salvage radical prostatectomy.
Cryoablation – This is an accepted treatment for recurrent prostate cancer after radiation therapy. The side effects are less than those for surgery, although it is unclear if cryoablation is as effective as surgery. Cryoablation can be repeated if necessary.
Transurethral resection of the prostate – TURP may be offered for castrate-resistant or hormone-refractory prostate cancer. This surgery is used to relieve symptoms of urinary obstruction caused by the prostate tumour (palliative surgery).
Biological therapy may be offered for recurrent prostate cancer. The type of biological therapy that may be given to men with recurrent prostate cancer is denosumab (Xgeva).
Bisphosphonates can be used for prostate cancer that has spread to the bone to relieve bone pain or prevent fractures in men with advanced castrate-resistant prostate cancer. The bisphosphonate used is zoledronic acid (Zometa).
Men with prostate cancer may be offered the opportunity to participate in clinical trials. For more information, go to clinical trials.