How is prostate cancer treated?

Written by Liu Liang
Oncology
Updated on February 23, 2025
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The treatment principles of prostate cancer vary with different stages. For clinical stage T1-T2N0M0 prostate cancer, which is early-stage, patients can choose radical prostatectomy or radical radiotherapy. For patients with locally advanced prostate cancer, specifically staged T3 or T4 but without lymph node or distant metastasis, options include radiotherapy combined with hormonal therapy or solely hormonal therapy. For patients with distant metastasis, which indicates advanced-stage prostate cancer, treatment primarily involves hormonal therapy. If hormonal therapy fails, chemotherapy may be utilized. Additionally, for pain caused by bone metastasis, local radiotherapy or radionuclide therapy can be integrated into the comprehensive treatment approach.

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Written by Liu Liang
Oncology
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Typical symptoms of prostate cancer

Early-stage prostate patients often do not exhibit significant clinical symptoms. However, when the prostate cancer tumor invades the surrounding tissues and structures, it can cause corresponding clinical manifestations such as urinary tract irritation and urinary obstruction. Symptoms include difficulty urinating or frequent urination, painful urination, and even urinary incontinence, perineal pain, and sciatica. Bone metastasis is a common site of metastasis in prostate cancer patients, causing pain in the affected area and even pathological fractures.

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Written by Zhou Zi Hua
Oncology
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How to treat bone metastases from prostate cancer?

The treatment of bone metastases from prostate cancer can include first-line hormonal therapy. During hormonal treatment, bisphosphonates can be used in conjunction to increase bone density. Additionally, external radiation therapy can improve localized bone pain. Patients with multiple bone metastases or bone pain can undergo radionuclide therapy. Another method is the use of analgesic drug therapy, which is also a main approach to alleviate pain from bone metastases of prostate cancer.

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Written by Zhou Zi Hua
Oncology
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androgen deprivation therapy for prostate cancer

Androgen deprivation therapy for prostate cancer includes surgical castration, which can quickly and continuously reduce levels to very low levels. The second is medical castration, which involves the use of analogs of luteinizing hormone-releasing hormone. Currently available products include leuprolide, goserelin, and triptorelin. Third, estrogen therapy, with diethylstilbestrol being the most common estrogen treatment. Surgical castration, medical castration, or estrogen therapy offer similar progression-free survival rates in patients with tumor-related outcomes.

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Written by Zhou Zi Hua
Oncology
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Endocrine therapy after radical prostatectomy for prostate cancer

Endocrine therapy after radical prostatectomy for prostate cancer is equivalent to adjuvant endocrine therapy for prostate cancer. Its purpose is to treat residual lesions, positive residual lymph nodes, and microscopic metastatic foci, thereby improving long-term survival rates. Currently, the indications for adjuvant endocrine therapy are based on postoperative pathology-positive results, positive lymph nodes post-surgery, and postoperative pathology confirmation of stage T3 or T4, but with high-risk factors. According to major guidelines, the duration of adjuvant endocrine therapy should be at least eighteen months.

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Written by Liu Liang
Oncology
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Is chemotherapy for prostate cancer painful?

For patients with advanced prostate cancer, endocrine therapy is primarily used. Chemotherapy is generally chosen when endocrine therapy is resistant and ineffective. The side effects of chemotherapy are similar to those of other chemotherapy treatments. The first is the gastrointestinal side effects, such as nausea, vomiting, decreased appetite, or bloating and abdominal pain. The second is bone marrow suppression, which leads to a decrease in white blood cells and platelets. The side effects of chemotherapy vary with each patient's constitution and other factors. In most cases, with the support of medications for stomach protection, anti-nausea, and increasing white blood cells, the majority of patients can generally tolerate the treatment.