What are the treatments for advanced prostate cancer?

The treatments for advanced prostate cancer mainly include endocrine therapy, chemotherapy, targeted therapy, immunotherapy, radionuclide therapy, etc.

1. Endocrine therapy

Endocrine therapy is the basic treatment for advanced prostate cancer. It mainly controls tumor growth by inhibiting the production of androgens or blocking their effects. Commonly used drugs include gonadotropin-releasing hormone analogues such as goserelin injection and leuprolide acetate sustained-release microspheres, as well as anti-androgens such as bicalutamide tablets and enzalutamide soft capsules. This type of treatment may cause side effects such as hot flashes and osteoporosis, and requires calcium and vitamin D to prevent bone loss.

2. Chemotherapy

Docetaxel injection is a standard chemotherapy drug for advanced prostate cancer and is often used in combination with prednisone tablets. Chemotherapy is suitable for patients who fail endocrine therapy or have visceral metastasis. It can prolong survival but may cause adverse reactions such as bone marrow suppression and peripheral neuropathy. Routine blood tests need to be monitored regularly during treatment, and granulocyte colony-stimulating factor should be used for supportive treatment if necessary.

3. Targeted therapy

PARP inhibitors such as Lynparza capsules can be used for patients with metastatic castration-resistant prostate cancer carrying BRCA gene mutations. Targeted drugs act specifically on the molecular targets of tumor cells and are highly precise. Common side effects include anemia, nausea, etc. Genetic testing is required to screen those who will benefit before taking the drug.

4. Immunotherapy

Immune checkpoint inhibitors such as pembrolizumab injection are suitable for advanced patients with high-grade microsatellite instability or mismatch repair deficiency. This type of drug fights tumors by activating T cells and may cause immune-related pneumonia, colitis and other adverse events. Close monitoring and timely use of glucocorticoids are required.

5. Radionuclide treatment

Radium-223 dichloride injection can selectively deposit in bone metastases, relieve bone pain and prolong survival by releasing alpha particles. The treatment is suitable for patients with mainly bone metastasis and no obvious visceral metastasis. The common adverse reaction is bone marrow suppression. The bone marrow reserve function needs to be assessed before administration, and it should be administered intravenously every 6 weeks for a maximum of 6 cycles.

Patients with advanced prostate cancer should maintain a high-protein diet such as fish, eggs, and milk, and supplement with appropriate amounts of vitamin D and calcium to maintain bone health. Perform low-intensity exercises such as walking and Tai Chi according to your physical condition to avoid the risk of falling. Regularly monitor prostate-specific antigen levels and imaging changes, and promptly communicate with the attending doctor to adjust the treatment plan. When the pain is severe, you can use oxycodone hydrochloride sustained-release tablets and other analgesics as directed by your doctor, and receive psychological counseling to improve your quality of life.