A Treatment Path for Advanced Prostate Cancer

Below is a suggested treatment route for those with advanced prostate cancer. It may not be applicable to every man, so it is always important to follow the advice of your medical professional.

LHRH analogue
(eg Zoladex)

+ Docetaxel

Bicalutamide
(Casodex)

Dexamethosone + Radium-223

Abiraterone or Enzalutamide

Cabazitaxel

Now that the first results of the STAMPEDE trial have shown the efficacy of using chemotherapy at the same time as first-line hormone therapy, men can now receive this with their LHRH analogue (e.g. Zoladex or Prostap). The PSA should fall dramatically to an acceptable level. Treatment with these hormone drugs will continue, either continously or intermittently, until such time as PSA begins to rise.

At this stage an anti-androgen such as Casodex may be used. The steroid Dexamethosone could follow, which can be used in conjunction with Radium-223. As steroids are only effective for a limited amount of time, newer drugs such as Abiraterone or Enzalutamide can follow; for some, but not all men, these may be very effective. Cabazitaxel, a more recent chemotherapy
treatment, may be used if the advanced drugs prove ineffective.

The programme above is flexible and can continue over many years. New treatments are being developed in many different countries. Keep optimistic.