A subsidiary of the University Medical Center Hamburg-Eppendorf

A subsidiary of the University Medical Center Hamburg-Eppendorf

Measurable PSA level despite surgery or radiotherapy

Cause for optimism, even with advanced cancer

If surgery or radiotherapy has not fully cured the prostate cancer and metastases appear at a later date, or if the initial diagnosis identifies metastases in the bones, lymph nodes or organs, drug therapy should be used to treat the tumour disease. In the latter case, it is important to carefully weigh up the potential benefits of additional local treatment (radiotherapy or prostate surgery).

As the male sex hormone testosterone regulates the growth of cancer cells, drug-based androgen-deprivation therapy can control the tumour and arrest its growth for a prolonged period, though it cannot cure the disease. Antiandrogen drugs in tablet form can block the effects of the hormone. This shields the tumour cells against testosterone without significantly reducing the level of testosterone in the blood.  

One alternative to antiandrogen therapy is GnRH analogues and antagonists, which are a form of androgen-deprivation therapy administered as depot injections. These medications prevent the production of testosterone in the testicles. Although this method does not remove the tumour, it can slow or even stop the cancer’s progression.  

Of course, testosterone deprivation entails certain side effects in the form of hot flushes, muscle wasting, osteoporosis, loss of libido (sexual interest) and potency, weight gain and anaemia. It is therefore vital to weigh up the circumstances in which drug therapy involving androgen deprivation appears medically sensible.

Martini-Klinik

Accompanies you through this topic

Prof. Dr. Thomas Steuber
Faculty member

We advise patients with advanced prostate cancer

The specialists at the Martini-Klinik offer the full spectrum of drug therapy options for advanced prostate carcinoma. We will draw up an individual treatment plan, taking into account your tumour’s stage and your circumstances, during our special consultation clinic.*

The treatment of patients with an advanced form of the disease often requires various specialist disciplines to work together. With this in mind, our interdisciplinary tumour board meets once per month, bringing together oncologists, radiotherapists and nuclear medicine specialists to make treatment decisions.

When is drug therapy recommended for prostate cancer?

If surgery or radiotherapy has not fully cured the prostate cancer and metastases appear at a later date, or if the initial diagnosis identifies metastases, drug therapy should be used to treat the tumour disease. In the latter case, it is important to carefully weigh up the potential benefits of additional local treatment (radiotherapy or prostate surgery).

Drug-based androgen-deprivation therapy can control the tumour and arrest its growth for a prolonged period but cannot cure the disease. On average, androgen deprivation can result in tumour progression after 24 months. This situation is known as castration-resistant prostate cancer. In this case, there are numerous substances with different mechanisms of action that can achieve success. The uro-oncological tumour board at a prostate cancer centre can make a recommendation about which drugs should be used and at which stage of cancer development, carefully considering the patient’s age, the characteristics of their tumour, and the potential benefits and side effects of the medication.