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84

NCCN Guidelines for Patients

®

Prostate Cancer, Version 1.2016

side effects are too severe. If docetaxel’s side effects

are too severe, you may be given mitoxantrone.

Mitoxantrone is a chemotherapy drug. It may improve

your quality of life, but it isn’t likely to increase how

long you will live.

Radium-223

Newer research supports use of radium-223 if the

cancer has metastasized to the bone but not to the

internal organs. In clinical trials, radium-223 was

shown to extend the lives of men by an average

of about 4 months. Your results may be the same,

better, or worse. Radium-223 also reduced the pain

caused by the bone metastases and the use of pain

medication.

Clinical trial

A clinical trial is a type of research that studies how

well a treatment works. Because of clinical trials, the

treatments in this book are now widely used to help

men with prostate cancer. There may be a clinical trial

that you may join.

Secondary hormone therapy

Compared to abiraterone acetate, these treatments have

only minor benefits. If your first hormone therapy was

surgical or medical castration, starting CAB or switching

to a new antiandrogen may help. If you’re already on

CAB, stopping your use of the antiandrogen—known

as antiandrogen withdrawal—may help if the cancer

cells are using the antiandrogen to grow. This effect is

called the antiandrogen withdrawal response and usually

lasts several months. Other medicines that may lower

testosterone levels include ketoconazole with or without

hydrocortisone, steroids, DES, and other estrogens.

7

Treatment guide: Systemic treatment

Castration-recurrent prostate cancer