What should you know about metastatic prostate cancer treatment options?

When prostate cancer has spread, treatment usually addresses cancer throughout the body and any areas causing symptoms or risk. The team considers where the cancer is, how quickly it is changing, tumour features, earlier treatment, other health conditions and your goals. Monitoring may include symptoms, examination, blood tests and imaging, with the plan adjusted when the cancer responds, remains stable or changes.

Hormone-directed treatment reduces signals that can drive prostate cancer. Additional systemic medicines may be used when appropriate. Radiotherapy can target a painful or threatening area; targeted radioisotope therapy may deliver radiation to selected cancer cells. Bone-strengthening therapy may help protect bone health in suitable situations.

Ask for the purpose of each proposed treatment, how it is given, how response will be checked and which side effects should be reported. Tell the team about heart disease, diabetes, medicines, dental problems, falls, urinary symptoms and any change in pain. Keeping a written symptom diary can show whether pain, sleep, mobility or urination is changing.

Surgery on the prostate is not automatically the main treatment after spread has occurred, but procedures may be discussed in selected circumstances. Brachytherapy, radiotherapy and robotic cancer surgery each have different uses, so the reason for recommending one matters more than its name.

Seek urgent medical help for new weakness or numbness in the legs, trouble walking, loss of bladder or bowel control, inability to pass urine, severe back pain, sudden breathlessness or confusion. Contact the oncology team promptly for fever, dehydration, persistent vomiting, rapidly worsening pain or a new symptom after treatment.

Which treatment is intended to control cancer throughout the body? Could a local treatment help a particular site? What alternatives fit my priorities? How will side effects affect work, intimacy, movement or sleep, and who should I call outside appointments?