Metastatic Prostate Cancer Treatment

Clinical Trials of Metastatic Prostate Cancer Treatment

Many techniques are being tried in investigational studies. They have not been used in enough patients or for a long enough time to prove themselves better than conventional treatment for metastatic prostate cancer.
Some of these techniques include:
  • Cryosurgery
  • Early hormonal therapy
  • Chemotherapy
  • Conformal radiation therapy.
Cryosurgery uses liquid nitrogen to freeze and kill prostate cancer cells. Guided by transrectal ultrasound (TRUS), the doctor places needles in preselected locations in the prostate gland. The needle tracks are dilated for the thin metal cryo probes to be inserted through the skin of the perineum into the prostate. Liquid nitrogen in the cryo probes forms an ice ball that freezes the prostate cancer cells; as the cells thaw, they rupture.
The procedure takes about two hours, requires anesthesia (either general or spinal), and requires one or two days in the hospital.
During cryosurgery, a warming catheter inserted through the penis protects the urethra, and incontinence is seldom a problem. However, the overlying nerve bundles usually freeze, so most men become impotent.
Early Hormonal Therapy
Early or neoadjuvant hormonal therapy is started as soon as prostate cancer is diagnosed, in hopes of slowing the growth of cancer that has spread into nearby tissues or of cancer that has invaded the lymph nodes. Given prior to surgery, neoadjuvant hormonal therapy often helps to shrink a tumor.
Chemotherapy, which kills fast-growing cells, has not proven particularly effective against slow-growing prostate cancer cells. Several promising new anticancer drugs are under study, being added to either surgery or radiation therapy for men with stage III prostate cancer. Chemotherapy is also being tried in conjunction with hormonal therapy for men whose advanced cancers are no longer responsive to hormonal therapy alone.
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