Prostate Cancer: Treatment Options for Late-Stage Cancer

Treatment choices for a man with prostate cancer depend on several things. These include his age and overall health, size and location of the cancer, the results of lab tests, and the stage of the cancer. When prostate cancer has spread to places in your body not near your prostate, it's called advanced or late-stage prostate cancer. It's also called metastatic prostate cancer. Your health care provider may advise 1 or more of these treatments if you have late-stage prostate cancer.

Hormone therapy (androgen deprivation therapy)

The goal of hormone treatment is to lower or block male hormones, such as testosterone. These types of hormones cause the cancer to grow. They can be blocked in a few ways. One way is through hormone shots. These are done once a month or every several months. Another way is to have surgery to remove the testicles. The testicles make testosterone. Pills can also be taken to help control hormones. These aren’t often used on their own. Hormone treatment does not cure prostate cancer, but it slows its growth. Hormone therapy can be used alone, or it can be used with radiation.

Radiation therapy

If your cancer has spread far from your prostate, such as to your bones, you may be given radiation therapy to help ease pain or other symptoms. This is done with external radiation, also called EBRT. For this, a machine sends a beam of radiation to your prostate. If the cancer has spread to many bones, you may have an injection of a radioactive medicine instead.


Chemotherapy is the use of medicines to slow the growth of cancer and reduce symptoms. It’s most often used if cancer has stopped responding to hormone treatment. Chemotherapy does not cure the cancer. It can decrease the pain from with prostate cancer, shrink the tumor, lower the levels of PSA, and may help you live longer.

Vaccine therapy

A vaccine is a type of medicine that can help boost the immune system. Vaccines are usually to help protect the body against infections. Sipuleucel-T is a vaccine that can be used to boost the immune system to help treat prostate cancer. It is used to treat late-stage prostate cancer that is no longer reacting to hormone therapy. The vaccine does not cure prostate cancer. But it can often help men live longer.

Bone-directed therapy

If prostate cancer spreads, it often goes to the bones first. This can cause pain and other symptoms. Different types of medicines can be used to help slow the growth of the cancer in bones and help relieve symptoms. 

Making treatment decisions

Your health care provider may advise a specific treatment. Or he or she may offer more than 1, giving you a choice. This can be a hard decision to make. Each type of treatment has different benefits and risks. You may want to learn all you can about your disease and treatment choices so that you can make decisions about your care.

Ask your health care provider questions such as:

  • What the goal of treatment is

  • How successful the treatment usually is

  • What are the risks and possible side effects 

  • How much a treatment is likely to cost

  • If a treatment will affect your urinary or sexual function

  • How the treatment will change your daily life

  • How your diet might have to change

  • How you will look and feel

Talk with your health care provider to get answers to your questions, and take the time to make the best decision for you.