Prognosis for Hormone Refractory Prostate Cancer

Hormone refractory prostate cancer (HRPC) is a difficult diagnosis for men and their families to hear. HRPC is characterized by continually rising PSA (prostate specific antigen) levels despite the use of hormone blocking agents. Optimal lifestyle choices, a series of treatment strategies and new clinical trials, along with alternative therapies, have made it possible to increase survival time while preserving quality of life. Although there is no cure for HRPC, you can fight the disease if you are determined to take charge of your treatment.

Verify Your Diagnosis

• Learn the medical terminology, and understand what your test results mean. A diagnosis of HRPC means that hormone therapy failed to reduce your testosterone levels to below 20 nanograms/milliliter. Check that you had regular blood tests during hormone therapy and that those tests showed that hormone therapy reduced your testosterone levels sufficiently.

Learn Your Options

• Select a medical team that is invested in helping you manage your own care. Your team may include an oncologist, family doctor, psychotherapist, nutritionist, immunologist, an alternative practitioner and perhaps other specialists such as a cardiologist. Learn what other treatments are available even when hormone blockage therapies have failed. Work with your medical team to determine which of those therapies would be most beneficial to you. Involve your family in the decision-making process.

Maintain Your Health

• Prostate cancer patients benefit from regular exercise. Talk with a nutritionist, and eat a balanced diet and take supplements if necessary. Take your medications regularly and on time. Get sufficient sleep. Visit your physician and seek treatment at the first sign of other health problems. Regularly update your medical team on your state of health.

Track Your Metastatic Disease

• Prostate cancer typically metastasizes, or spreads, to bone, but you can also have soft tissue tumors that form in muscle, fat, lymph, cartilage, nerves or blood vessels. Your doctor will probably schedule repeated bone, CT, MRI and/or PET scans to see if tumors are present. Any pain or bleeding can be an indication of a soft tissue tumor.

Choose Your Therapies

• After first-line hormone therapies have failed, treatment options usually start with second-line hormonal therapies, which can be administered in sequence for maximum benefit. Sometimes chemotherapy is given at the same time or begun after hormone therapy. Chemotherapy is sometimes also sequenced with other types of treatment. You may also receive radiation treatments. Your medical team may recommend that you enter an HRPC clinical trial.

Prognosis

• According to an April 2004 paper in The Journal of Urology (Survival of Patients with Hormone Refractory Prostate Cancer in the Prostate Specific Antigen Era), the average survival after being diagnosed with HRPC and no bone metastasis was 68 months. Men with bone metastases survived an average of 40 months after being diagnosed with HRPC.