What is the Best Treatment for Metastatic Prostate Cancer?

Stage 4 prostate cancer, also known as metastatic cancer, is a severe cancer stage that requires immediate medical attention. Your doctor can recommend you get some tests and procedures to confirm your stage 4 diagnosis and determine where your cancer has spread in the body.

They plan and develop a comprehensive treatment plan designed especially for you based on this. Let’s discuss stage 4 and some of its best treatment options in detail.

Stages of Prostate Cancer

The prostate is a small gland located below the bladder that produces semen. The uncontrolled growth of cells leads to the formation of cancer in the prostate.

There are 4 stages of prostate cancer. The staging is done to determine the size of the tumor and extent of spread, and severity.

  • Stage I: This is the earliest stage of cancer, where it is slowly growing.
  • Stage II: The tumor at this stage is restricted to the prostate. Here the cancer is small but is at the risk of growing and spreading.
  • Stage III: The cancer is locally advanced and is likely to grow and spread in this stage.
  • Stage IV is the most advanced stage where cancer has spread beyond the prostate.
    1. Stage IVA: The tumor is spread across regional lymph nodes.
    2. Stage IVB: The tumor has spread to distant lymph nodes and other body parts, including the bones.

Metastatic Prostate Cancer

Stage 4 cancer is referred to as metastatic cancer because it indicates that cancer has spread from its origin to different parts of the body. This stage is often detected years after an initial prostate cancer diagnosis or after primary cancer or prostate has been removed or treated.

Metastatic prostate cancer usually spreads across the adrenal glands, bones, liver, and lungs.


Stage 4 cancer is often difficult to cure, but various treatments can help to slow its growth and extend your life.

1. Hormone Therapy

This treatment aims to stop your body from making testosterone (male hormone). This prevents testosterone from showing any harmful effects on cancer. Stopping the hormone supply can help to shrink cancer and slow its growth.

Hormone therapy includes medications that help to stop testosterone production. Some of these medications include:

  • Leuprolide
  • Histrelin
  • Triptorelin
  • Degarelix

Sometimes surgical removal of testicles (orchiectomy) reduces testosterone levels.

2. Radiation therapy

In this therapy, high-powered energy beams, such as photons or X-rays, are used to destroy cancer cells. These beams are emitted by large machines that rotate around your body and are directed to the area around cancer.

Radiation therapy is combined with hormone therapy in men with extensive cancers spread to nearby lymph nodes. Besides killing cancer cells, this therapy relieves pain and other symptoms.

3. Surgery

Surgery is often recommended to relieve signs and symptoms such as difficulty urinating.

Two types of surgeries are done:

  1. Radical proctectomy removes the entire prostate and any tumor that grows locally beyond the gland.
  2. Lymph node removal is when your doctor removes several lymph nodes surrounding the prostate (dissection of pelvic lymph nodes). This is usually done to test for cancer cells and prevent the further spread of cancer.

4. Chemotherapy

Chemotherapy helps slow down prostate cancer cells’ growth, relieve signs of cancer, and extend life, especially in advanced prostate cancer.

The most common chemotherapeutic agent used for prostate cancer is docetaxel and steroid medicine (prednisolone). This therapy helps improve disease-related symptoms, like pain and fatigue.

5. Immunotherapy

Immunotherapy utilizes your immune system to kill cancer cells and prevent their growth. This therapy trains your immune system to recognize cancer cells and destroy them. Drugs such as Sipuleucel-T (Provenge), a form of immunotherapy, have been developed to genetically engineer the immune cells in your body to fight prostate cancer.

6. Supportive (palliative) care

Palliative care is focused on providing relief from symptoms of a severe illness, such as extreme pain. Palliative care specialists work with you, your family members, and other healthcare professionals to provide extra support that complements your ongoing care.

Palliative care can also be given with other aggressive treatments, such as chemotherapy, surgery, or radiation therapy.


Metastatic prostate cancer is a very rarely diagnosed disease. Prostate cancer is mainly diagnosed early when the cancer is confined to the prostate.

Treatments help slow or shrink an advanced prostate cancer, but stage 4 prostate cancer is not treatable for most men. Still, various treatment options help extend your life and reduce the signs & symptoms of cancer.

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