Treatment of stage III prostate cancer
The following are treatment options for stage III prostate cancer. The types of treatments given are based on the unique needs of the person with cancer.
Radiation therapy has traditionally been considered the first choice of treatment for stage III prostate cancer. It is given together with hormonal therapy for stage III cancer. The type of radiation therapy used is external beam radiation therapy. Brachytherapy is not an option for stage III cancer.
External beam radiation therapy can also be given after a radical prostatectomy (adjuvant radiation) to reduce the risk of the cancer returning in the area of the prostate. This is done more frequently for stage III prostate cancer.
Hormonal therapy may be offered for stage III prostate cancer:
- in combination with radiation therapy
- Hormonal therapy drugs may be given for a period of time before, during and after radiation therapy, for a period of 1 to 3 years.
- alone as a primary treatment for men who cannot have radiation therapy or surgery
The types of hormonal therapy are:
- luteinizing hormone-releasing hormone (LHRH) agonists
- leuprolide (Lupron, Lupron Depot, Eligard)
- goserelin (Zoladex)
- buserelin (Suprefact)
- LHRH antagonist
- degarelix (Firmagon)
- flutamide (Euflex)
- bicalutamide (Casodex)
- nilutamide (Anandron)
- surgical removal of the testicles (orchiectomy)
Surgery may be offered for stage III prostate cancer. The types of surgery are:
- transurethral resection of the prostate (TURP)
- to relieve the symptoms of prostate cancer, but not to treat the tumour
- sometimes done before starting radiation therapy or hormonal therapy
- radical prostatectomy
- In the past, surgery was not offered to men with stage III prostate cancer because it was considered difficult to remove the entire cancer. This has changed, and there is evidence that surgery is at least as good as radiation therapy.
- Surgery may be better than the combination of radiation therapy and hormonal therapy in some men because it can be combined with post-operative radiation.
- The combination of surgery and radiation therapy may avoid the need for hormonal therapy and its associated side effects.
Men with prostate cancer may be offered the opportunity to participate in clinical trials. For more information, go to clinical trials.
Clinical trial discovery improves quality of life
A clinical trial led by the Society’s NCIC Clinical Trials group found that men with prostate cancer who are treated with intermittent courses of hormone therapy live as long as those receiving continuous therapy.