This fact sheet is for men who have been diagnosed with advanced (metastatic) prostate cancer - cancer that has spread from the prostate to other parts of the body. It explains what advanced prostate cancer is, what your test results mean, and the treatments available.

References  

  • Abrahamsen B, Brask-Lindemann D, Rubin KH, Schwarz P. A review of lifestyle, smoking and other modifiable risk factors for osteoporotic fractures. BoneKEy Rep. 2014 Sep 3;3:574.
  • Adler RA. Management of osteoporosis in men on androgen deprivation therapy. Maturitas. 2011 Feb;68(2):143–7.
  • Ahmadi H, Daneshmand S. Androgen deprivation therapy for prostate cancer: long-term safety and patient outcomes. Patient Relat Outcome Meas. 2014 Jul;63.
  • Ahmadi H, Daneshmand S. Androgen deprivation therapy: evidence-based management of side effects: Androgen deprivation therapy. BJU Int. 2013 Apr;111(4):543–8.
  • Alibhai SMH, Gogov S, Allibhai Z. Long-term side effects of androgen deprivation therapy in men with non-metastatic prostate cancer: A systematic literature review. Crit Rev Oncol Hematol. 2006 Dec;60(3):201–15.
  • Allott EH, Masko EM, Freedland SJ. Obesity and Prostate Cancer: Weighing the Evidence. Eur Urol. 2013 May;63(5):800–9.
  • Baumann FT, Zopf EM, Bloch W. Clinical exercise interventions in prostate cancer patients: a systematic review of randomized controlled trials. Support Care Cancer. 2012;20(2):221–33.
  • Bower JE, Bak K, Berger A, Breitbart W, Escalante CP, Ganz PA, et al. Screening, Assessment, and Management of Fatigue in Adult Survivors of Cancer: An American Society of Clinical Oncology Clinical Practice Guideline Adaptation. J Clin Oncol. 2014 Jun 10;32(17):1840–50.
  • Bubendorf L, Schöpfer A, Wagner U, Sauter G, Moch H, Willi N, et al. Metastatic patterns of prostate cancer: an autopsy study of 1,589 patients. Hum Pathol. 2000 May;31(5):578–83.
  • Carlin BI, Andriole GL. The natural history, skeletal complications, and management of bone metastases in patients with prostate carcinoma. Cancer. 2000;88(S12):2989–2994.
  • Chen KW, Berger CC, Manheimer E, Forde D, Magidson J, Dachman L, et al. Meditative therapies for reducing anxiety: a systematic review and meta-analysis of randomized controlled trials. Depress Anxiety. 2012 Jul;29(7):545–62.
  • Cheung AS, Zajac JD, Grossmann M. Muscle and bone effects of androgen deprivation therapy: current and emerging therapies. Endocr Relat Cancer. 2014 Sep 17;21(5):R371–94.
  • Chipperfield K, Brooker J, Fletcher J, Burney S. The impact of physical activity on psychosocial outcomes in men receiving androgen deprivation therapy for prostate cancer: A systematic review. Health Psychol. 2014;33(11):1288–97.
  • Cormie P, Galvão DA, Spry N, Joseph D, Chee R, Taaffe DR, et al. Can supervised exercise prevent treatment toxicity in patients with prostate cancer initiating androgen-deprivation therapy: a randomised controlled trial. BJU Int. 2015;115(2):256–66.
  • Cormie P, Newton RU, Taaffe DR, Spry N, Joseph D, Hamid MA, et al. Exercise maintains sexual activity in men undergoing androgen suppression for prostate cancer: a randomized controlled trial. Prostate Cancer Prostatic Dis. 2013;16(2):170–175.
  • Davies NJ, Batehup L, Thomas R. The role of diet and physical activity in breast, colorectal, and prostate cancer survivorship: a review of the literature. Br J Cancer. 2011 Nov 8;105:S52–73.
  • De Laet C, Kanis JA, Odén A, Johanson H, Johnell O, Delmas P, et al. Body mass index as a predictor of fracture risk: A meta-analysis. Osteoporos Int. 2005 Nov;16(11):1330–8.
  • Dorff TB, Crawford ED. Management and challenges of corticosteroid therapy in men with metastatic castrate-resistant prostate cancer. Ann Oncol. 2013 Jan 1;24(1):31–8.
  • Eastham JA. Bone health in men receiving androgen deprivation therapy for prostate cancer. J Urol. 2007 Jan;177(1):17–24.
  • Elliott S, Latini DM, Walker LM, Wassersug R, Robinson JW. Androgen Deprivation Therapy for Prostate Cancer: Recommendations to Improve Patient and Partner Quality of Life: Improving Life on ADT. J Sex Med. 2010 Sep;7(9):2996–3010.
  • Food, Nutrition, Physical Activity and the Prevention of Cancer: A Global Perspective [Internet]. WCRF/AICR Expert Report. Available from: http://www.dietandcancerreport.org
  • Gardner JR, Livingston PM, Fraser SF. Effects of Exercise on Treatment-Related Adverse Effects for Patients With Prostate Cancer Receiving Androgen-Deprivation Therapy: A Systematic Review. J Clin Oncol. 2014 Feb 1;32(4):335–46.
  • Goyal M, Singh S, Sibinga EMS, Gould NF, Rowland-Seymour A, Sharma R, et al. Meditation programs for psychological stress and well-being: a systematic review and meta-analysis. JAMA Intern Med. 2014 Mar;174(3):357–68.
  • Grossmann M, Hamilton EJ, Gilfillan C, Bolton D, Joon DL, Zajac JD. Bone and metabolic health in patients with non-metastatic prostate cancer who are receiving androgen deprivation therapy. Med J Aust. 2011;194(6):301–306.
  • Hamilton K, Chambers SK, Legg M, Oliffe JL, Cormie P. Sexuality and exercise in men undergoing androgen deprivation therapy for prostate cancer. Support Care Cancer. 2015 Jan;23(1):133–42.
  • Haseen F, Murray LJ, Cardwell CR, O’Sullivan JM, Cantwell MM. The effect of androgen deprivation therapy on body composition in men with prostate cancer: Systematic review and meta-analysis. J Cancer Surviv. 2010 Jun 1;4(2):128–39.
  • Hori S, Butler E, McLoughlin J. Prostate cancer and diet: food for thought? BJU Int. 2011;107(9):1348–1359.
  • Islami F, Moreira DM, Boffetta P, Freedland SJ. A Systematic Review and Meta-analysis of Tobacco Use and Prostate Cancer Mortality and Incidence in Prospective Cohort Studies. Eur Urol. 2014 Dec;66(6):1054–64.
  • Iversen P, Karup C, Van der Meulen E, Tanko LB, Huhtaniemi I. Hot flushes in prostatic cancer patients during androgen-deprivation therapy with monthly dose of degarelix or leuprolide. Prostate Cancer Prostatic Dis. 2011;14(2):184–190.
  • James ND, Sydes MR, Clarke NW, Mason MD, Dearnaley DP, Spears MR, et al. Addition of docetaxel, zoledronic acid, or both to first-line long-term hormone therapy in prostate cancer (STAMPEDE): survival results from an adaptive, multiarm, multistage, platform randomised controlled trial. The Lancet. 2015 Dec;
  • Jespersen CG, Nørgaard M, Borre M. Androgen-deprivation Therapy in Treatment of Prostate Cancer and Risk of Myocardial Infarction and Stroke: A Nationwide Danish Population-based Cohort Study. Eur Urol. 2014 Apr;65(4):704–9.
  • Keogh JWL, MacLeod RD. Body Composition, Physical Fitness, Functional Performance, Quality of Life, and Fatigue Benefits of Exercise for Prostate Cancer Patients: A Systematic Review. J Pain Symptom Manage. 2012 Jan;43(1):96–110.
  • Keto CJ, Aronson WJ, Terris MK, Presti JC, Kane CJ, Amling CL, et al. Obesity is associated with castration-resistant disease and metastasis in men treated with androgen deprivation therapy after radical prostatectomy: results from the SEARCH database. BJU Int. 2011;110(4):492–8.
  • Kurzrock R. The role of cytokines in cancer-related fatigue. Cancer. 2001;92(S6):1684–1688.
  • Larkin D, Lopez V, Aromataris E. Managing cancer-related fatigue in men with prostate cancer: A systematic review of non-pharmacological interventions: Managing prostate cancer fatigue. Int J Nurs Pract. 2014 Oct;20(5):549–60.
  • Mishra SI, Scherer RW, Geigle PM, Berlanstein DR, Topaloglu O, Gotay CC, et al. Exercise interventions on health-related quality of life for cancer survivors. Cochrane Database Syst Rev. 2012;8:CD007566.
  • Moch H, Humphrey PA, Ulbright TM, Reuter VE, editors. WHO Classification of tumours of the urinary system and male genital organs [Internet]. 4th ed. Vol. 8. World Health Organization; 2016. Available from: http://apps.who.int/bookorders/anglais/detart1.jsp?codlan=1&codcol=70&codcch=4008
  • Moreira DM, Aronson WJ, Terris MK, Kane CJ, Amling CL, Cooperberg MR, et al. Cigarette smoking is associated with an increased risk of biochemical disease recurrence, metastasis, castration-resistant prostate cancer, and mortality after radical prostatectomy: Results from the SEARCH database. Cancer. 2014 Jan 15;120(2):197–204.
  • Mottet N, Bellmunt J, Briers E, Bolla M, Cornford P, De Santis M, et al. Guidelines on prostate cancer. European Association of Urology; 2016.
  • Murphy R, Wassersug R, Dechman G. The role of exercise in managing the adverse effects of androgen deprivation therapy in men with prostate cancer. Phys Ther Rev. 2011 Aug 1;16(4):269–77.
  • National Insitute for Health and Care Excellence. Prostate cancer (hormone relapsed, metastatic) - cabazitaxel (after docetaxel) (review TA255). Final appraisal determination document April 2016. 2016.
  • National Institute for Health and Care Excellence (NICE). Osteoporosis - prevention of fragility fractures - Clinical Knowledge Summary [Internet]. 2016. Available from: http://cks.nice.org.uk/osteoporosis-prevention-of-fragility-fractures#!scenario:1
  • National Institute for Health and Care Excellence. Prostate Cancer: diagnosis and treatment. Full guideline 175. 2014.
  • National Institute of Clinical Excellence. Docetaxel for the treatment of hormone-refractory prostate cancer. NICE; 2006.
  • Neto AS, Tobias-Machado M, Esteves MAP, Senra MD, Wroclawski ML, Fonseca FLA, et al. Bisphosphonate therapy in patients under androgen deprivation therapy for prostate cancer: a systematic review and meta-analysis. Prostate Cancer Prostatic Dis. 2012;15(1):36–44.
  • NHS England. Clinical Commissioning Policy Statement: Docetaxel in combination with androgen deprivation therapy for the treatment of hormone naive metastatic prostate cancer. 2016.
  • Oefelein MG, Ricchuiti V, Conrad W, Seftel A, Bodner D, Goldman H, et al. Skeletal fracture associated with androgen suppression induced osteoporosis: the clinical incidence and risk factors for patients with prostate cancer. J Urol. 2001;166(5):1724–1728.
  • Parker C, Nilsson S, Heinrich D, Helle SI, O’Sullivan JM, Fosså SD, et al. Alpha Emitter Radium-223 and Survival in Metastatic Prostate Cancer. N Engl J Med. 2013;369(3):213–23.
  • Planas J, Morote J, Orsola A, Salvador C, Trilla E, Cecchini L, et al. The relationship between daily calcium intake and bone mineral density in men with prostate cancer. BJU Int. 2007 Apr;99(4):812–6.
  • Public Health England. Prostate cancer risk management programme (PCRMP): benefits and risks of PSA testing [Internet]. GOV.UK; 2016. Available from: https://www.gov.uk/government/publications/prostate-cancer-risk-management-programme-psa-test-benefits-and-risks/prostate-cancer-risk-management-programme-pcrmp-benefits-and-risks-of-psa-testing
  • Richman EL, Kenfield SA, Stampfer MJ, Paciorek A, Carroll PR, Chan JM. Physical Activity after Diagnosis and Risk of Prostate Cancer Progression: Data from the Cancer of the Prostate Strategic Urologic Research Endeavor. Cancer Res. 2011 May 24;71(11):3889–95.
  • Ryan CW, Huo D, Stallings JW, Davis RL, Beer TM, McWhorter LT. Lifestyle Factors and Duration of Androgen Deprivation Affect Bone Mineral Density of Patients with Prostate Cancer During First Year of Therapy. Urology. 2007 Jul;70(1):122–6.
  • Sanofi-Aventis. TAXOTERE® (docetaxel) Injection Concentrate - Prescribing Information. 2014.
  • Saylor PJ, Smith MR. Metabolic Complications of Androgen Deprivation Therapy for Prostate Cancer. J Urol. 2013 Jan;189(1):S34–44.
  • Scottish Medicines Consortium. Scottish Medicines Consortium. Cabazitaxel, 60mg concentrate and solvent for solution for infusion (Jevtana®). SMC No.735/11. 2016.
  • Secretan B, Straif K, Baan R, Grosse Y, El Ghissassi F, Bouvard V, et al. A review of human carcinogens—Part E: tobacco, areca nut, alcohol, coal smoke, and salted fish. Lancet Oncol. 2009 Nov;10(11):1033–4.
  • Serpa Neto A, Tobias-Machado M, Kaliks R, Wroclawski ML, Pompeo ACL, Del Giglio A. Ten Years of Docetaxel-Based Therapies in Prostate Adenocarcinoma: A Systematic Review and Meta-Analysis of 2244 Patients in 12 Randomized Clinical Trials. Clin Genitourin Cancer. 2011 Dec;9(2):115–23.
  • Singer EA, Srinivasan R. Intravenous therapies for castration-resistant prostate cancer: Toxicities and adverse events. Urol Oncol Semin Orig Investig. 2012 Jul;30(4):S15–9.
  • Stene GB, Helbostad JL, Balstad TR, Riphagen II, Kaasa S, Oldervoll LM. Effect of physical exercise on muscle mass and strength in cancer patients during treatment—A systematic review. Crit Rev Oncol Hematol. 2013 Dec;88(3):573–93.
  • Storey DJ, McLaren DB, Atkinson MA, Butcher I, Frew LC, Smyth JF, et al. Clinically relevant fatigue in men with hormone-sensitive prostate cancer on long-term androgen deprivation therapy. Ann Oncol. 2012;23(6):1542–9.
  • Tucci M, Bertaglia V, Vignani F, Buttigliero C, Fiori C, Porpiglia F, et al. Addition of Docetaxel to Androgen Deprivation Therapy for Patients with Hormone-sensitive Metastatic Prostate Cancer: A Systematic Review and Meta-analysis. Eur Urol. 2015 Sep;
  • Vale CL, Burdett S, Rydzewska LH, Albiges L, Clarke NW, Fisher D, et al. Addition of docetaxel or bisphosphonates to standard of care in men with localised or metastatic, hormone-sensitive prostate cancer: a systematic review and meta-analyses of aggregate data. Lancet Oncol. 2015;
  • Winters-Stone KM, Dobek JC, Bennett JA, Dieckmann NF, Maddalozzo GF, Ryan CW, et al. Resistance Training Reduces Disability in Prostate Cancer Survivors on Androgen Deprivation Therapy: Evidence From a Randomized Controlled Trial. Arch Phys Med Rehabil. 2015 Jan;96(1):7–14.
  • Zhao J, Zhu S, Sun L, Meng F, Zhao L, Zhao Y, et al. Androgen Deprivation Therapy for Prostate Cancer Is Associated with Cardiovascular Morbidity and Mortality: A Meta-Analysis of Population-Based Observational Studies. Kyprianou N, editor. PLoS ONE. 2014 Sep 29;9(9):e107516.
  • Zu K, Giovannucci E. Smoking and aggressive prostate cancer: a review of the epidemiologic evidence. Cancer Causes Control. 2009 Jun 27;20(10):1799–810.

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Updated: November 2016 | Due for Review: November 2018

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