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.
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
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.
Treatment guide: Systemic treatment
Castration-recurrent prostate cancer