Advanced Prostate Cancer
Once prostate cancer spreads out of prostate, we focus on medical treatments to reduce its symptoms and prevent its further spread. As with all advanced genitourinary cancers, we take a team approach to its treatment, working with the doctors of the Perlmutter Cancer Center to determine the most appropriate treatment options.
Hormone-sensitive prostate cancer
Hormone-sensitive prostate cancer is sensitive to variations in levels of the male hormone testosterone. Medically eliminating circulating male hormones ("hormone ablation") can help prevent the cancer’s spread. Hormone ablation uses several medications to shut down the body's production of testosterone.
Although this is a common first treatment for metastatic prostate cancer, it carries the risk of side effects such as osteoporosis, loss of cognitive function, loss of energy, loss of muscle mass and increased risk of diabetes and cardiovascular disease. As a result of these potential side effects, we exercise caution with this therapy. NYU urologists are investigating medications to reverse some of the side effects of hormone-ablative therapy.
Hormone-refractory prostate cancer
Hormone-refractory prostate cancer is no longer sensitive to hormone ablation therapy. We use second-line hormonal therapies to block hormone receptors on the cancer cells as an alternative means of preventing cancer growth. Physicians at the Perlmutter Cancer Center are investigating how to improve this line of treatment, researching other means to block cancer cells’ growth.
If there is no response to this second-line therapy, chemotherapy is usually prescribed. NYU urologists and cancer researchers are also investigating the use of chemotherapy earlier in the treatment of prostate cancer.
In addition to these medical treatments, we sometimes prescribe radiation therapy to relieve symptoms such as bleeding, obstruction or bone pain as a result of metastatic prostate cancer.