Prostate cancer uses male testosterone to grow. ADT, or hormone therapy, works by lowering the body’s testosterone level to slow prostate cancer growth. ADT is often used to treat prostate cancer that has spread to other sites in the body. Side effects are possible, including fatigue, weight gain, weakened bones, muscle reduction, sexual dysfunction, and possible susceptibility to hot flashes.

Advanced prostate cancer as well as the treatments for it can weaken the bones and increase the risk of fractures. Prolia® and Xgeva® (denosumab) are bone-strengthening drugs that slow down the bone-weakening process. Vitamin D, calcium supplements, and regular exercise are also important for bone health.

Chemotherapy is sometimes combined with hormone therapy to treat prostate cancer that has spread into bones or other organs. 

There are a number of medications for treating cancer that has spread beyond the prostate: Nubeqa® (darolutamide), Erleada® (apalutamide), Xtandi® (enzalutamide), Zytiga® (abiraterone acetate). Often, these drugs are used when the cancer is no longer responding to androgen deprivation therapy or can be used if prostate cancer has spread outside of the prostate.

Radiation therapy can help relieve pain from prostate cancer that has spread to bones. It is also used to treat prostate cancer that has limited spread to other parts of the body. Radiation therapy is delivered by a radiation oncologist. Urology of St. Louis partners with various radiation centers of excellence for prostate cancer in the St. Louis metro area.

Provenge® is a medication used to treat prostate cancer that has spread outside of the prostate to other parts of the body. It is a unique medication for prostate cancer in that is a type of immunotherapy that activates the body’s immune system to find prostate cancer cells to attack them. 

Xofigo® is a type of radiation therapy used to treat prostate cancer that has spread to bone and causes pain. It is delivered through an IV by a radiation oncologist.