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<div class="pre-content"><div><div class="bk_prnt"><p class="small">NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.</p><p>PDQ Cancer Information Summaries [Internet]. Bethesda (MD): National Cancer Institute (US); 2002-. </p></div><div class="iconblock clearfix whole_rhythm no_top_margin bk_noprnt"><a class="img_link icnblk_img" title="Table of Contents Page" href="/books/n/pdqcis/"><img class="source-thumb" src="/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-pdqcis-lrg.png" alt="Cover of PDQ Cancer Information Summaries" height="100px" width="80px" /></a><div class="icnblk_cntnt eight_col"><h2>PDQ Cancer Information Summaries [Internet].</h2><a data-jig="ncbitoggler" href="#__NBK65915_dtls__">Show details</a><div style="display:none" class="ui-widget" id="__NBK65915_dtls__"><div>Bethesda (MD): <a href="http://www.cancer.gov/" ref="pagearea=page-banner&targetsite=external&targetcat=link&targettype=publisher">National Cancer Institute (US)</a>; 2002-.</div></div><div class="half_rhythm"></div><div class="bk_noprnt"><form method="get" action="/books/n/pdqcis/" id="bk_srch"><div class="bk_search"><label for="bk_term" class="offscreen_noflow">Search term</label><input type="text" title="Search this book" id="bk_term" name="term" value="" data-jig="ncbiclearbutton" /> <input type="submit" class="jig-ncbibutton" value="Search this book" submit="false" style="padding: 0.1em 0.4em;" /></div></form></div></div></div></div></div>
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<div class="main-content lit-style" itemscope="itemscope" itemtype="http://schema.org/CreativeWork"><div class="meta-content fm-sec"><h1 id="_NBK65915_"><span class="title" itemprop="name">Prostate Cancer Treatment (PDQ®)</span></h1><div class="subtitle whole_rhythm">Patient Version</div><p class="contrib-group"><span itemprop="author">PDQ Adult Treatment Editorial Board</span>.</p><p class="small">Published online: July 31, 2015.</p></div><div class="jig-ncbiinpagenav body-content whole_rhythm" data-jigconfig="allHeadingLevels: ['h2'],smoothScroll: false" itemprop="text"><div id="_abs_rndgid_" itemprop="description"><p id="CDR0000062965__324">This PDQ cancer information summary has current information about the treatment of prostate cancer. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.</p><p id="CDR0000062965__325">Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Date Last Modified") is the date of the most recent change. The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the PDQ Adult Treatment Editorial Board.</p></div><div id="CDR0000062965__102"><h2 id="_CDR0000062965__102_">General Information About Prostate Cancer</h2><div class="box"><h4><span class="title">Key Points for This Section</span></h4><ul><li class="half_rhythm"><div><a href="#CDR0000062965__103">Prostate cancer is a disease in which malignant (cancer) cells
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|
form in the tissues of the prostate.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062965__107">Signs of prostate cancer include a weak flow of urine
|
|
or frequent urination. </a></div></li><li class="half_rhythm"><div><a href="#CDR0000062965__111">Tests that examine the prostate and blood are used to
|
|
detect (find) and diagnose prostate cancer.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062965__206">Certain factors affect prognosis (chance of recovery) and treatment options.</a></div></li></ul></div><div id="CDR0000062965__103"><h3>Prostate cancer is a disease in which malignant (cancer) cells
|
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form in the tissues of the prostate.</h3><p id="CDR0000062965__105">The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046539/" class="def">prostate</a> is a
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046386/" class="def">gland</a> in the male
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046564/" class="def">reproductive system</a>. It lies just
|
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below the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046501/" class="def">bladder</a> (the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000257523/" class="def">organ</a> that
|
|
collects and empties <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046642/" class="def">urine</a>) and in
|
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front of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046555/" class="def">rectum</a> (the lower part
|
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of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046335/" class="def">intestine</a>). It is about the
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size of a walnut and surrounds part of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046640/" class="def">urethra</a> (the tube that empties urine from the
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bladder). The prostate gland makes <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044669/" class="def">fluid</a> that is part of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046703/" class="def">semen</a>.<div class="iconblock whole_rhythm clearfix ten_col fig" id="figCDR0000062965219" co-legend-rid="figlgndCDR0000062965219"><a href="/books/NBK65915.1/figure/CDR0000062965__219/?report=objectonly" target="object" title="Figure" class="img_link icnblk_img figpopup" rid-figpopup="figCDR0000062965219" rid-ob="figobCDR0000062965219"><img class="small-thumb" src="/books/NBK65915.1/bin/CDR0000450023.gif" src-large="/books/NBK65915.1/bin/CDR0000450023.jpg" alt="Anatomy of the male reproductive and urinary systems, showing the prostate, testicles, bladder, and other organs" /></a><div class="icnblk_cntnt" id="figlgndCDR0000062965219"><h4 id="CDR0000062965__219"><a href="/books/NBK65915.1/figure/CDR0000062965__219/?report=objectonly" target="object" rid-ob="figobCDR0000062965219">Figure</a></h4><p class="float-caption no_bottom_margin">Anatomy of the male reproductive and urinary systems, showing the prostate, testicles, bladder, and other organs. </p></div></div></p><p id="CDR0000062965__106"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000445079/" class="def">Prostate cancer</a> is found
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mainly in older men. In the U.S., about 1 out of 5 men will be <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046450/" class="def">diagnosed</a> with prostate cancer. </p></div><div id="CDR0000062965__107"><h3>Signs of prostate cancer include a weak flow of urine
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or frequent urination. </h3><p id="CDR0000062965__109">These and other <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000750109/" class="def">signs</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045022/" class="def">symptoms</a> may be caused by prostate cancer or by other <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651193/" class="def">conditions</a>. Check with your doctor if you have any of the following:</p><ul id="CDR0000062965__110"><li class="half_rhythm"><div>Weak or interrupted ("stop-and-go") flow of urine.</div></li><li class="half_rhythm"><div>Sudden urge to urinate.</div></li><li class="half_rhythm"><div>Frequent urination (especially at night).</div></li><li class="half_rhythm"><div>Trouble starting the flow of urine.</div></li><li class="half_rhythm"><div>Trouble emptying the bladder completely.</div></li><li class="half_rhythm"><div>Pain or burning while urinating.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270735/" class="def">Blood</a> in the urine or semen.</div></li><li class="half_rhythm"><div>A pain in the back, hips, or
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046246/" class="def">pelvis</a> that doesn't go away.</div></li><li class="half_rhythm"><div>Shortness of breath, feeling very tired, fast heartbeat, dizziness, or pale skin caused by <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045360/" class="def">anemia</a>.</div></li></ul><p id="CDR0000062965__285">Other conditions may cause the same symptoms. As men age, the prostate may get bigger and block the
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urethra or bladder. This may cause trouble urinating or sexual problems. The condition is called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046509/" class="def">benign prostatic hyperplasia</a> (BPH), and although
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it is not cancer, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">surgery</a> may be
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needed. The symptoms
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of benign prostatic hyperplasia or of other problems in the prostate may be
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like symptoms of prostate cancer.</p><div class="iconblock whole_rhythm clearfix ten_col fig" id="figCDR0000062965220" co-legend-rid="figlgndCDR0000062965220"><a href="/books/NBK65915.1/figure/CDR0000062965__220/?report=objectonly" target="object" title="Figure" class="img_link icnblk_img figpopup" rid-figpopup="figCDR0000062965220" rid-ob="figobCDR0000062965220"><img class="small-thumb" src="/books/NBK65915.1/bin/CDR0000462221.gif" src-large="/books/NBK65915.1/bin/CDR0000462221.jpg" alt="Normal prostate and benign prostatic hyperplasia (BPH)" /></a><div class="icnblk_cntnt" id="figlgndCDR0000062965220"><h4 id="CDR0000062965__220"><a href="/books/NBK65915.1/figure/CDR0000062965__220/?report=objectonly" target="object" rid-ob="figobCDR0000062965220">Figure</a></h4><p class="float-caption no_bottom_margin">Normal prostate and benign prostatic hyperplasia (BPH). A normal prostate does not block the flow of urine from the bladder. An enlarged prostate presses on the bladder and urethra and blocks the flow of urine. </p></div></div></div><div id="CDR0000062965__111"><h3>Tests that examine the prostate and blood are used to
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detect (find) and diagnose prostate cancer.</h3><p id="CDR0000062965__113">The following tests and procedures may be used:</p><ul id="CDR0000062965__114"><li class="half_rhythm"><div class="half_rhythm"><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270871/" class="def">Physical exam</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000689078/" class="def">history</a></b>: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.</div></li><li class="half_rhythm"><div class="half_rhythm"><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045668/" class="def">Digital rectal
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exam</a> (DRE)</b>: An exam of the rectum. The doctor or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000269445/" class="def">nurse</a> inserts a lubricated, gloved finger into the rectum and feels the prostate through the rectal wall for lumps or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044636/" class="def">abnormal</a> areas. <div class="iconblock whole_rhythm clearfix ten_col fig" id="figCDR0000062965221" co-legend-rid="figlgndCDR0000062965221"><a href="/books/NBK65915.1/figure/CDR0000062965__221/?report=objectonly" target="object" title="Figure" class="img_link icnblk_img figpopup" rid-figpopup="figCDR0000062965221" rid-ob="figobCDR0000062965221"><img class="small-thumb" src="/books/NBK65915.1/bin/CDR0000457840.gif" src-large="/books/NBK65915.1/bin/CDR0000457840.jpg" alt="Digital rectal exam (DRE)" /></a><div class="icnblk_cntnt" id="figlgndCDR0000062965221"><h4 id="CDR0000062965__221"><a href="/books/NBK65915.1/figure/CDR0000062965__221/?report=objectonly" target="object" rid-ob="figobCDR0000062965221">Figure</a></h4><p class="float-caption no_bottom_margin">Digital rectal exam (DRE). The doctor inserts a gloved, lubricated finger into the rectum and feels the prostate to check for anything abnormal. </p></div></div></div></li><li class="half_rhythm"><div class="half_rhythm">
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<b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000322878/" class="def">Prostate-specific antigen (PSA) test</a></b>: A test that measures the level of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044867/" class="def">PSA</a> in the blood. PSA is a substance made by the prostate that may be found in an increased amount in the blood of men who have prostate cancer. PSA levels may also be high in men who have an <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045364/" class="def">infection</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044042/" class="def">inflammation</a> of the prostate or BPH (an enlarged, but noncancerous, prostate).</div></li><li class="half_rhythm"><div class="half_rhythm">
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<b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046632/" class="def">Transrectal
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ultrasound</a></b>: A procedure in which a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000367430/" class="def">probe</a> that is about the size of a finger is inserted into the rectum to check the prostate. The probe is used to bounce high-energy sound waves (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046157/" class="def">ultrasound</a>) off internal <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissues</a> or organs and make echoes. The echoes form a picture of body tissues called a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046587/" class="def">sonogram</a>. Transrectal ultrasound may be used during a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045164/" class="def">biopsy</a> procedure.<div class="iconblock whole_rhythm clearfix ten_col fig" id="figCDR0000062965222" co-legend-rid="figlgndCDR0000062965222"><a href="/books/NBK65915.1/figure/CDR0000062965__222/?report=objectonly" target="object" title="Figure" class="img_link icnblk_img figpopup" rid-figpopup="figCDR0000062965222" rid-ob="figobCDR0000062965222"><img class="small-thumb" src="/books/NBK65915.1/bin/CDR0000446202.gif" src-large="/books/NBK65915.1/bin/CDR0000446202.jpg" alt="Transrectal ultrasound" /></a><div class="icnblk_cntnt" id="figlgndCDR0000062965222"><h4 id="CDR0000062965__222"><a href="/books/NBK65915.1/figure/CDR0000062965__222/?report=objectonly" target="object" rid-ob="figobCDR0000062965222">Figure</a></h4><p class="float-caption no_bottom_margin">Transrectal ultrasound. An ultrasound probe is inserted into the rectum to check the prostate. The probe bounces sound waves off body tissues to make echoes that form a sonogram (computer picture) of the prostate. </p></div></div></div></li><li class="half_rhythm"><div class="half_rhythm"><b>Transrectal <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045997/" class="def">magnetic resonance imaging</a> (MRI)</b>: A procedure that uses a strong magnet, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651209/" class="def">radio waves</a>, and a computer to make a series of detailed pictures of areas inside the body. A probe that gives off radio waves is inserted into the rectum near the prostate. This helps the MRI machine make clearer pictures of the prostate and nearby tissue. A transrectal MRI is done to find out if the cancer has spread outside the prostate into nearby tissues. This procedure is also called nuclear magnetic resonance imaging (NMRI).</div></li><li class="half_rhythm"><div class="half_rhythm">
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<b>Biopsy</b>: The removal of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a> or tissues so they can be viewed under a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000638184/" class="def">microscope</a> by a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046244/" class="def">pathologist</a>. The pathologist will
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check the tissue sample to see if there are cancer cells and find out the
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045696/" class="def">Gleason score</a>. The Gleason score
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ranges from 2-10 and describes how likely it is that a
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> will spread. The lower the
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number, the less likely the tumor is to spread.</div><div class="half_rhythm"> A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000322891/" class="def">transrectal biopsy</a> is used to
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diagnose prostate cancer. A transrectal biopsy is the removal of tissue from the prostate by inserting a thin needle through the rectum and into the prostate. This procedure is usually done using transrectal ultrasound to help guide where samples of tissue are taken from. A pathologist views the tissue under a microscope to look for cancer cells. <div class="iconblock whole_rhythm clearfix ten_col fig" id="figCDR0000062965223" co-legend-rid="figlgndCDR0000062965223"><a href="/books/NBK65915.1/figure/CDR0000062965__223/?report=objectonly" target="object" title="Figure" class="img_link icnblk_img figpopup" rid-figpopup="figCDR0000062965223" rid-ob="figobCDR0000062965223"><img class="small-thumb" src="/books/NBK65915.1/bin/CDR0000446226.gif" src-large="/books/NBK65915.1/bin/CDR0000446226.jpg" alt="Transrectal biopsy" /></a><div class="icnblk_cntnt" id="figlgndCDR0000062965223"><h4 id="CDR0000062965__223"><a href="/books/NBK65915.1/figure/CDR0000062965__223/?report=objectonly" target="object" rid-ob="figobCDR0000062965223">Figure</a></h4><p class="float-caption no_bottom_margin">Transrectal biopsy. An ultrasound probe is inserted into the rectum to show where the tumor is. Then a needle is inserted through the rectum into the prostate to remove tissue from the prostate. </p></div></div></div></li></ul></div><div id="CDR0000062965__206"><h3>Certain factors affect prognosis (chance of recovery) and treatment options.</h3><p id="CDR0000062965__208">The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045849/" class="def">prognosis</a> (chance of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000454708/" class="def">recovery</a>) and treatment options depend on the following:</p><ul id="CDR0000062965__209"><li class="half_rhythm"><div>The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045885/" class="def">stage</a> of the cancer (level of PSA, Gleason score, grade of the tumor, how much of the prostate is affected by the cancer, and whether the cancer has spread to other places in the
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body).</div></li><li class="half_rhythm"><div>The patient’s age.</div></li><li class="half_rhythm"><div>Whether the cancer has just been diagnosed or has <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046556/" class="def">recurred</a> (come back).</div></li></ul><p id="CDR0000062965__212">Treatment options also may depend on the following:</p><ul id="CDR0000062965__287"><li class="half_rhythm"><div>Whether the patient has other health problems.</div></li><li class="half_rhythm"><div>The expected <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046580/" class="def">side effects</a> of treatment.</div></li><li class="half_rhythm"><div>Past treatment for prostate cancer.</div></li><li class="half_rhythm"><div>The wishes of the patient.</div></li></ul><p id="CDR0000062965__288">Most men diagnosed with prostate cancer do not die of it.</p></div></div><div id="CDR0000062965__120"><h2 id="_CDR0000062965__120_">Stages of Prostate Cancer</h2><div class="box"><h4><span class="title">Key Points for This Section</span></h4><ul><li class="half_rhythm"><div><a href="#CDR0000062965__121">After prostate cancer has been diagnosed, tests are done to
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find out if cancer cells have spread within the prostate or to other parts of
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the body. </a></div></li><li class="half_rhythm"><div><a href="#CDR0000062965__236">There are three ways that cancer spreads in the body.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062965__313">Cancer may spread from where it began to other parts of the body.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062965__126">The following stages are used for prostate cancer:</a></div></li></ul></div><div id="CDR0000062965__121"><h3>After prostate cancer has been diagnosed, tests are done to
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find out if cancer cells have spread within the prostate or to other parts of
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the body. </h3><p id="CDR0000062965__123">The process used to find out if <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> has spread within the
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046539/" class="def">prostate</a> or to other parts of the
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body is called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046597/" class="def">staging</a>. The information gathered from the
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staging process determines the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045885/" class="def">stage</a> of the disease. It is
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important to know the stage in order to plan treatment. The results of the tests used to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046450/" class="def">diagnose</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000445079/" class="def">prostate cancer</a> are often also used to stage the disease. (See the <a href="#CDR0000062965__111">General Information section</a>.) In prostate cancer, staging tests may not be done unless the patient has <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045022/" class="def">symptoms</a> or signs that the cancer has spread, such as bone pain, a high <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044867/" class="def">PSA</a> level, or a high <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045696/" class="def">Gleason score</a>.</p><p id="CDR0000062965__289">The following tests and procedures also may be used in the staging process:</p><ul id="CDR0000062965__124"><li class="half_rhythm"><div>
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<b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046499/" class="def">Bone
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scan</a></b>: A procedure to check if there are rapidly dividing <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a>, such as cancer cells, in the bone. A very small amount of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046550/" class="def">radioactive</a> material is <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044678/" class="def">injected</a> into a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000476471/" class="def">vein</a> and travels through the bloodstream. The radioactive material collects in the bones and is detected by a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046570/" class="def">scanner</a>.
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<div class="iconblock whole_rhythm clearfix ten_col fig" id="figCDR0000062965229" co-legend-rid="figlgndCDR0000062965229"><a href="/books/NBK65915.1/figure/CDR0000062965__229/?report=objectonly" target="object" title="Figure" class="img_link icnblk_img figpopup" rid-figpopup="figCDR0000062965229" rid-ob="figobCDR0000062965229"><img class="small-thumb" src="/books/NBK65915.1/bin/CDR0000466541.gif" src-large="/books/NBK65915.1/bin/CDR0000466541.jpg" alt="Bone scan" /></a><div class="icnblk_cntnt" id="figlgndCDR0000062965229"><h4 id="CDR0000062965__229"><a href="/books/NBK65915.1/figure/CDR0000062965__229/?report=objectonly" target="object" rid-ob="figobCDR0000062965229">Figure</a></h4><p class="float-caption no_bottom_margin">Bone scan. A small amount of radioactive material is injected into the patient's bloodstream and collects in abnormal cells in the bones. As the patient lies on a table that slides under the scanner, the radioactive material is detected and images are <a href="/books/NBK65915.1/figure/CDR0000062965__229/?report=objectonly" target="object" rid-ob="figobCDR0000062965229">(more...)</a></p></div></div></div></li><li class="half_rhythm"><div>
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<b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045788/" class="def">MRI</a> (magnetic
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resonance imaging)</b>: A procedure that uses a magnet, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651209/" class="def">radio waves</a>, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI).</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046033/" class="def">CT scan</a> (CAT scan)</b>:
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A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045944/" class="def">x-ray</a> machine. A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000409764/" class="def">dye</a> may be injected into a vein or swallowed to help the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000257523/" class="def">organs</a> or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000322876/" class="def">Pelvic lymphadenectomy</a></b>:
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A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">surgical</a> procedure to remove the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a> in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046246/" class="def">pelvis</a>. A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046244/" class="def">pathologist</a> views the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissue</a> under a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000638184/" class="def">microscope</a> to look for cancer cells.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000322882/" class="def">Seminal vesicle biopsy</a></b>: The removal of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044669/" class="def">fluid</a> from the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046576/" class="def">seminal vesicles</a> (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046386/" class="def">glands</a> that make <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046703/" class="def">semen</a>) using a needle. A pathologist views the fluid under a microscope to look for cancer cells.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000597165/" class="def">ProstaScint scan</a></b>: A procedure to check for cancer that has spread from the prostate to other parts of the body, such as the lymph nodes. A very small amount of radioactive material is injected into a vein and travels through the bloodstream. The radioactive material attaches to prostate cancer cells and is detected by a scanner. The radioactive material shows up as a bright spot on the picture in areas where there are a lot of prostate cancer cells.</div></li></ul><p id="CDR0000062965__125">The stage of the cancer is based on the results of the staging and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045959/" class="def">diagnostic tests</a>, including
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the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651204/" class="def">prostate-specific antigen (PSA) test</a> and the Gleason score. The tissue samples removed during the biopsy are used to find out the Gleason score. The Gleason score ranges from 2-10 and describes how different the cancer cells look from normal cells and how likely it is that the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> will spread. The lower the number, the less likely the tumor is to spread.</p></div><div id="CDR0000062965__236"><h3>There are three ways that cancer spreads in the body.</h3><p id="CDR0000062965__236_69">Cancer can spread through <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissue</a>, the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045764/" class="def">lymph system</a>, and the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270735/" class="def">blood</a>:</p><ul id="CDR0000062965__236_70"><li class="half_rhythm"><div>Tissue. The cancer spreads from where it began by growing into nearby areas.
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</div></li><li class="half_rhythm"><div>Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000269462/" class="def">lymph vessels</a> to other parts of the body.
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</div></li><li class="half_rhythm"><div>Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045020/" class="def">blood vessels</a> to other parts of the body.
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</div></li></ul></div><div id="CDR0000062965__313"><h3>Cancer may spread from where it began to other parts of the body.</h3><p id="CDR0000062965__313_66">When cancer spreads to another part of the body, it is called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046710/" class="def">metastasis</a>. Cancer <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a> break away from where they began (the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045847/" class="def">primary tumor</a>) and travel through the lymph system or blood.</p><ul id="CDR0000062965__313_67"><li class="half_rhythm"><div>Lymph system. The cancer gets into the lymph system, travels through the lymph vessels, and forms a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044058/" class="def">metastatic</a> tumor) in another part of the body.</div></li><li class="half_rhythm"><div>Blood. The cancer gets into the blood, travels through the blood vessels, and forms a tumor (metastatic tumor) in another part of the body.</div></li></ul><p id="CDR0000062965__315">The metastatic tumor is the same type of cancer as the primary tumor. For example, if prostate cancer spreads to the bone, the cancer cells in the bone are actually prostate cancer cells. The disease is metastatic prostate cancer, not bone cancer.</p><p id="CDR0000062965__322"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000514443/" class="def">Denosumab</a>, a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046066/" class="def">monoclonal antibody</a>, may be used to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000439419/" class="def">prevent</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045317/" class="def">bone metastases</a>.</p></div><div id="CDR0000062965__126"><h3>The following stages are used for prostate cancer:</h3><div class="iconblock whole_rhythm clearfix ten_col fig" id="figCDR0000062965226" co-legend-rid="figlgndCDR0000062965226"><a href="/books/NBK65915.1/figure/CDR0000062965__226/?report=objectonly" target="object" title="Figure" class="img_link icnblk_img figpopup" rid-figpopup="figCDR0000062965226" rid-ob="figobCDR0000062965226"><img class="small-thumb" src="/books/NBK65915.1/bin/CDR0000442273.gif" src-large="/books/NBK65915.1/bin/CDR0000442273.jpg" alt="As prostate cancer progresses from Stage I to Stage IV, the cancer cells grow within the prostate, through the outer layer of the prostate into nearby tissue, and then to lymph nodes or other parts of the body" /></a><div class="icnblk_cntnt" id="figlgndCDR0000062965226"><h4 id="CDR0000062965__226"><a href="/books/NBK65915.1/figure/CDR0000062965__226/?report=objectonly" target="object" rid-ob="figobCDR0000062965226">Figure</a></h4><p class="float-caption no_bottom_margin">As prostate cancer progresses from Stage I to Stage IV, the cancer cells grow within the prostate, through the outer layer of the prostate into nearby tissue, and then to lymph nodes or other parts of the body. </p></div></div><div id="CDR0000062965__128"><h4>Stage I</h4><p id="CDR0000062965__130">In <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045129/" class="def">stage I</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> is
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found in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046539/" class="def">prostate</a> only. The cancer: </p><ul id="CDR0000062965__261"><li class="half_rhythm"><div>is found by <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045798/" class="def">needle biopsy</a> (done for a high <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044867/" class="def">PSA</a> level) or in a small amount of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissue</a> during <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">surgery</a> for other reasons (such as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046509/" class="def">benign prostatic hyperplasia</a>). The PSA level is lower than 10 and the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045696/" class="def">Gleason score</a> is 6 or lower; or</div></li><li class="half_rhythm"><div>is found in one-half or less of one <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046188/" class="def">lobe</a> of the prostate. The PSA level is lower than 10 and the Gleason score is 6 or lower; or</div></li><li class="half_rhythm"><div>cannot be felt during a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045668/" class="def">digital rectal exam</a> and cannot be seen in <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000689578/" class="def">imaging tests</a>. Cancer is found in one-half or less of one lobe of the prostate. The PSA level and the Gleason score are not known. </div></li></ul></div><div id="CDR0000062965__131"><h4>Stage II</h4><p id="CDR0000062965__133">In <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045130/" class="def">stage II</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> is
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more advanced than in <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045129/" class="def">stage I</a>, but has not spread outside the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046539/" class="def">prostate</a>. Stage II is divided into stages IIA and IIB.</p><p id="CDR0000062965__262">In <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045130/" class="def">stage IIA</a>, cancer:</p><ul id="CDR0000062965__268"><li class="half_rhythm"><div> is found by <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045798/" class="def">needle biopsy</a> (done for a high <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044867/" class="def">PSA</a> level) or in a small amount of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissue</a> during <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">surgery</a> for other reasons (such as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046509/" class="def">benign prostatic hyperplasia</a>). The PSA level is lower than 20 and the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045696/" class="def">Gleason score</a> is 7; or</div></li><li class="half_rhythm"><div> is found by needle biopsy (done for a high PSA level) or in a small amount of tissue during surgery for other reasons (such as benign prostatic hyperplasia). The PSA level is at least 10 but lower than 20 and the Gleason score is 6 or lower; or</div></li><li class="half_rhythm"><div>is found in one-half or less of one <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046188/" class="def">lobe</a> of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046539/" class="def">prostate</a>. The PSA level is at least 10 but lower than 20 and the Gleason score is 6 or lower; or</div></li><li class="half_rhythm"><div>is found in one-half or less of one lobe of the prostate. The PSA level is lower than 20 and the Gleason score is 7; or</div></li><li class="half_rhythm"><div>is found in more than one-half of one lobe of the prostate. </div></li></ul><p id="CDR0000062965__264">In <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045130/" class="def">stage IIB</a>, cancer:</p><ul id="CDR0000062965__265"><li class="half_rhythm"><div>is found in opposite sides of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046539/" class="def">prostate</a>. The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044867/" class="def">PSA</a> can be any level and the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045696/" class="def">Gleason score</a> can range from 2 to 10; or</div></li><li class="half_rhythm"><div>cannot be felt during a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045668/" class="def">digital rectal exam</a> and cannot be seen in <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000689578/" class="def">imaging tests</a>. The PSA level is 20 or higher and the Gleason score can range from 2 to 10; or</div></li><li class="half_rhythm"><div>cannot be felt during a digital rectal exam and cannot be seen in imaging tests. The PSA can be any level and the Gleason score is 8 or higher.</div></li></ul></div><div id="CDR0000062965__134"><h4>Stage III</h4><p id="CDR0000062965__136">In <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045131/" class="def">stage III</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a>
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has spread beyond the outer layer of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046539/" class="def">prostate</a> and may have spread to the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046576/" class="def">seminal vesicles</a>. The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044867/" class="def">PSA</a> can be any level and the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045696/" class="def">Gleason score</a> can range from 2 to 10.</p></div><div id="CDR0000062965__137"><h4>Stage IV</h4><p id="CDR0000062965__267">In <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045132/" class="def">stage IV</a>, the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044867/" class="def">PSA</a> can be any level and the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045696/" class="def">Gleason score</a> can range from 2 to 10. Also, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a>:</p><ul id="CDR0000062965__266"><li class="half_rhythm"><div>has spread beyond the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046576/" class="def">seminal vesicles</a> to nearby <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissue</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000257523/" class="def">organs</a>, such as the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046555/" class="def">rectum</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046501/" class="def">bladder</a>, or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000410631/" class="def">pelvic wall</a>; or </div></li><li class="half_rhythm"><div>may have spread to the seminal vesicles or to nearby tissue or organs, such as the rectum, bladder, or pelvic wall. Cancer has spread to nearby <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a>; or</div></li><li class="half_rhythm"><div>has spread to distant parts of the body, which may include lymph nodes or bones. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000445079/" class="def">Prostate cancer</a> often spreads to the bones.</div></li></ul></div></div></div><div id="CDR0000062965__140"><h2 id="_CDR0000062965__140_">Recurrent Prostate Cancer</h2><p id="CDR0000062965__141"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045862/" class="def">Recurrent</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000445079/" class="def">prostate cancer</a> is <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> that has recurred (come back) after
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it has been treated. The cancer may come back in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046539/" class="def">prostate</a> or
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in other parts of the body. </p></div><div id="CDR0000062965__142"><h2 id="_CDR0000062965__142_">Treatment Option Overview</h2><div class="box"><h4><span class="title">Key Points for This Section</span></h4><ul><li class="half_rhythm"><div><a href="#CDR0000062965__143">There are different types of treatment for patients with prostate cancer.
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</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062965__147">Seven types of standard treatment are used:</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062965__316">There are treatments for bone pain caused by bone metastases or hormone therapy.
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</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062965__169">New types of treatment are being tested in clinical
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trials.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062965__248">Patients may want to think about taking part in a clinical trial.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062965__250">Patients can enter clinical trials before, during, or after starting their cancer treatment.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062965__252">Follow-up tests may be needed.</a></div></li></ul></div><div id="CDR0000062965__143"><h3>There are different types of treatment for patients with prostate cancer.
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</h3><p id="CDR0000062965__145">Different types of treatment are available for patients with
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000445079/" class="def">prostate cancer</a>. Some treatments are <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044930/" class="def">standard</a> (the currently used treatment), and some
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are being tested in <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trials</a>.
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A treatment clinical trial is a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651211/" class="def">research study</a> meant to help
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improve current treatments or obtain information on new treatments for patients
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with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a>. When clinical trials show that a new treatment is better than the
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standard treatment, the new
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treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.</p></div><div id="CDR0000062965__147"><h3>Seven types of standard treatment are used:</h3><div id="CDR0000062965__149"><h4>Watchful waiting
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or active surveillance</h4><p id="CDR0000062965__291"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045942/" class="def">Watchful waiting</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000616060/" class="def">active surveillance</a> are treatments used for older men who do not have <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000750109/" class="def">signs</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045022/" class="def">symptoms</a> or have other medical <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651193/" class="def">conditions</a> and for men whose prostate cancer is found during a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046171/" class="def">screening</a> test.</p><p id="CDR0000062965__151">Watchful waiting is closely <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000454803/" class="def">monitoring</a> a patient’s <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651193/" class="def">condition</a> without giving any treatment until signs or symptoms appear or change. Treatment is given to relieve symptoms and improve <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045417/" class="def">quality of life</a>.</p><p id="CDR0000062965__282">Active surveillance is closely following a patient's condition without giving any treatment unless there are changes in test results. It is used to find early signs that the condition is getting worse. In active surveillance, patients are given certain exams and tests, including <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045668/" class="def">digital rectal exam</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651204/" class="def">PSA test</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046632/" class="def">transrectal ultrasound</a>, and transrectal <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045798/" class="def">needle biopsy</a>, to check if the cancer is growing. When the cancer begins to grow, treatment is given to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000318813/" class="def">cure</a> the cancer.</p><p id="CDR0000062965__292">Other terms that are used to describe not giving treatment to cure prostate cancer right after <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046450/" class="def">diagnosis</a> are observation, watch and wait, and expectant management.</p></div><div id="CDR0000062965__152"><h4>Surgery </h4><p id="CDR0000062965__154">Patients in good health whose <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> is in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046539/" class="def">prostate</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046386/" class="def">gland</a> only may be treated with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">surgery</a> to remove the tumor. The following types of surgery are used: </p><ul id="CDR0000062965__155"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046549/" class="def">Radical
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prostatectomy</a>: A surgical procedure to remove the prostate, surrounding <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissue</a>, and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046576/" class="def">seminal vesicles</a>. There are two types of radical prostatectomy:
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<dl id="CDR0000062965__156" class="temp-labeled-list"><dt>-</dt><dd><p class="no_top_margin">
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046567/" class="def">Retropubic
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prostatectomy</a>: A surgical procedure to remove the prostate through an <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046353/" class="def">incision</a> (cut) in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046684/" class="def">abdominal</a> wall. Removal of nearby <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a> may be done at the same time.</p></dd><dt>-</dt><dd><p class="no_top_margin">
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046232/" class="def">Perineal
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prostatectomy</a>: A surgical procedure to remove the prostate through an incision (cut) made in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000321384/" class="def">perineum</a> (area between the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046573/" class="def">scrotum</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046523/" class="def">anus</a>). Nearby lymph nodes may also be removed through a separate incision in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045070/" class="def">abdomen</a>.</p></dd></dl><div class="iconblock whole_rhythm clearfix ten_col fig" id="figCDR0000062965227" co-legend-rid="figlgndCDR0000062965227"><a href="/books/NBK65915.1/figure/CDR0000062965__227/?report=objectonly" target="object" title="Figure" class="img_link icnblk_img figpopup" rid-figpopup="figCDR0000062965227" rid-ob="figobCDR0000062965227"><img class="small-thumb" src="/books/NBK65915.1/bin/CDR0000442274.gif" src-large="/books/NBK65915.1/bin/CDR0000442274.jpg" alt="Two types of radical prostatectomy" /></a><div class="icnblk_cntnt" id="figlgndCDR0000062965227"><h4 id="CDR0000062965__227"><a href="/books/NBK65915.1/figure/CDR0000062965__227/?report=objectonly" target="object" rid-ob="figobCDR0000062965227">Figure</a></h4><p class="float-caption no_bottom_margin">Two types of radical prostatectomy. In a retropubic prostatectomy, the prostate is removed through an incision in the wall of the abdomen. In a perineal prostatectomy, the prostate is removed through an incision in the area between the scrotum and the <a href="/books/NBK65915.1/figure/CDR0000062965__227/?report=objectonly" target="object" rid-ob="figobCDR0000062965227">(more...)</a></p></div></div></div></li><li class="half_rhythm"><div>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000322876/" class="def">Pelvic lymphadenectomy</a>: A surgical procedure to remove the lymph nodes in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046246/" class="def">pelvis</a>. A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046244/" class="def">pathologist</a> views the tissue under a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000638184/" class="def">microscope</a> to look for cancer <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a>. If the lymph nodes contain cancer,
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the doctor will not remove the prostate and may recommend other
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treatment.</div></li><li class="half_rhythm"><div>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045932/" class="def">Transurethral resection of the
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prostate</a> (TURP): A surgical procedure to remove tissue from the prostate using a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000482456/" class="def">resectoscope</a> (a thin, lighted tube with a cutting tool) inserted through the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046640/" class="def">urethra</a>. This procedure is done to treat <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044372/" class="def">benign prostatic hypertrophy</a> and it is sometimes done to relieve symptoms caused by a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> before other cancer treatment is given. TURP may
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also be done in men whose tumor is in the prostate only and who cannot have a radical prostatectomy.<div class="iconblock whole_rhythm clearfix ten_col fig" id="figCDR0000062965228" co-legend-rid="figlgndCDR0000062965228"><a href="/books/NBK65915.1/figure/CDR0000062965__228/?report=objectonly" target="object" title="Figure" class="img_link icnblk_img figpopup" rid-figpopup="figCDR0000062965228" rid-ob="figobCDR0000062965228"><img class="small-thumb" src="/books/NBK65915.1/bin/CDR0000442342.gif" src-large="/books/NBK65915.1/bin/CDR0000442342.jpg" alt="Transurethral resection of the prostate (TURP)" /></a><div class="icnblk_cntnt" id="figlgndCDR0000062965228"><h4 id="CDR0000062965__228"><a href="/books/NBK65915.1/figure/CDR0000062965__228/?report=objectonly" target="object" rid-ob="figobCDR0000062965228">Figure</a></h4><p class="float-caption no_bottom_margin">Transurethral resection of the prostate (TURP). Tissue is removed from the prostate using a resectoscope (a thin, lighted tube with a cutting tool at the end) inserted through the urethra. Prostate tissue that is blocking the urethra is cut away and removed <a href="/books/NBK65915.1/figure/CDR0000062965__228/?report=objectonly" target="object" rid-ob="figobCDR0000062965228">(more...)</a></p></div></div></div></li></ul><p id="CDR0000062965__310">In
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some cases, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000373937/" class="def">nerve-sparing surgery</a> can be done. This
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type of surgery may save the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000373935/" class="def">nerves</a> that control <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000373933/" class="def">erection</a>. However, men with
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large tumors or tumors that are very close to the nerves may not be able to
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have this surgery. </p><p id="CDR0000062965__311">Possible problems after prostate cancer surgery include the following:</p><ul id="CDR0000062965__312"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000321376/" class="def">Impotence</a>.</div></li><li class="half_rhythm"><div>Leakage of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046642/" class="def">urine</a> from the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046501/" class="def">bladder</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046605/" class="def">stool</a> from the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046555/" class="def">rectum</a>. </div></li><li class="half_rhythm"><div>Shortening of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000257215/" class="def">penis</a> (1 to 2 <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000354457/" class="def">centimeters</a>). The exact reason for this is not known.</div></li><li class="half_rhythm"><div>Inguinal <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000630906/" class="def">hernia</a> (bulging of fat or part of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046582/" class="def">small intestine</a> through weak muscles into the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046375/" class="def">groin</a>). Inguinal hernia may occur more often in men treated with radical prostatectomy than in men who have some other types of prostate surgery, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">radiation therapy</a>, or prostate <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045164/" class="def">biopsy</a> alone. It is most likely to occur within the first 2 years after radical prostatectomy.</div></li></ul></div><div id="CDR0000062965__159"><h4>Radiation therapy and radiopharmaceutical therapy
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</h4><p id="CDR0000062965__161">Radiation therapy is a cancer treatment that uses high-energy <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045944/" class="def">x-rays</a> or other types of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045072/" class="def">radiation</a> to kill cancer cells or keep them from growing. There are different types of radiation therapy: </p><ul id="CDR0000062965__290"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046686/" class="def">External radiation therapy</a> uses a machine outside the body to send radiation toward the cancer. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270731/" class="def">Conformal radiation</a> is a type of external radiation therapy that uses a computer to create a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045582/" class="def">3-dimensional</a> (3-D) picture of the tumor. The radiation beams are shaped to fit the tumor.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046345/" class="def">Internal radiation therapy</a> uses a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046550/" class="def">radioactive</a> substance sealed in needles, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000257219/" class="def">seeds</a>, wires, or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045637/" class="def">catheters</a> that are placed directly into or near the cancer. In <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000561398/" class="def">early-stage</a> prostate cancer, the radioactive seeds are placed in the prostate using needles that are inserted through the skin between the scrotum and rectum. The placement of the radioactive seeds in the prostate is guided by images from <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046632/" class="def">transrectal ultrasound</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045560/" class="def">computed tomography</a> (CT). The needles are removed after the radioactive seeds are placed in the prostate.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046023/" class="def">Radiopharmaceutical</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044737/" class="def">therapy</a> uses a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046550/" class="def">radioactive</a> substance to treat cancer. Radiopharmaceutical therapy includes the following:<ul id="CDR0000062965__323"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000759898/" class="def">Alpha emitter radiation therapy</a> uses a radioactive substance to treat prostate cancer that has spread to the bone. A radioactive substance called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000749669/" class="def">radium-223</a> is <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044678/" class="def">injected</a> into a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000476471/" class="def">vein</a> and travels through the bloodstream. The radium-223 collects in areas of bone with cancer and kills the cancer cells.</div></li></ul></div></li></ul><p id="CDR0000062965__284">The way the radiation therapy is given depends on the type and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045885/" class="def">stage</a> of the cancer being treated.</p><p id="CDR0000062965__256">Men treated with radiation therapy for prostate cancer have an increased risk of having <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000444968/" class="def">bladder</a> and/or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045692/" class="def">gastrointestinal</a> cancer.</p><p id="CDR0000062965__162">Radiation therapy can cause <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000321376/" class="def">impotence</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044093/" class="def">urinary</a> problems.</p></div><div id="CDR0000062965__163"><h4>Hormone therapy
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</h4><p id="CDR0000062965__165"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045110/" class="def">Hormone therapy</a> is a cancer treatment that removes <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045713/" class="def">hormones</a> or blocks their action and stops cancer cells from growing. Hormones are substances made by <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046386/" class="def">glands</a> in the body and circulated in the bloodstream. In prostate cancer, male sex hormones can cause prostate cancer to grow. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000348921/" class="def">Drugs</a>, surgery, or other hormones are used to reduce the amount of male hormones or block them from working.
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</p><p id="CDR0000062965__166">Hormone therapy for prostate cancer may
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include the following:</p><ul id="CDR0000062965__167"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046304/" class="def">Luteinizing hormone-releasing
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hormone agonists</a> can stop the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046611/" class="def">testicles</a> from making
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045581/" class="def">testosterone</a>. Examples are <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000595341/" class="def">leuprolide</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045289/" class="def">goserelin</a>, and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045180/" class="def">buserelin</a>.</div></li><li class="half_rhythm"><div>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046052/" class="def">Antiandrogens</a>
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can block the action of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045592/" class="def">androgens</a>
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(hormones that promote male sex characteristics), such as testosterone. Examples are
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045264/" class="def">flutamide</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045354/" class="def">bicalutamide</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000740024/" class="def">enzalutamide</a>, and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045300/" class="def">nilutamide</a>.</div></li><li class="half_rhythm"><div>Drugs that can prevent the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046678/" class="def">adrenal glands</a> from making androgens include
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045222/" class="def">ketoconazole</a> and
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045170/" class="def">aminoglutethimide</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045441/" class="def">Orchiectomy</a> is
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a surgical procedure to remove one or both testicles, the main source of male hormones, such as testosterone, to decrease
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the amount of hormone being made. </div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046076/" class="def">Estrogens</a>
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(hormones that promote female sex characteristics) can prevent the
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testicles from making
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testosterone. However, estrogens are seldom used today in the treatment of
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prostate cancer because of the risk of serious <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046580/" class="def">side
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effects</a>.</div></li></ul><p id="CDR0000062965__168"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000256567/" class="def">Hot flashes</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000454756/" class="def">impaired</a> sexual function, loss of desire for sex, and weakened bones
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may occur in men treated with hormone therapy. Other <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046580/" class="def">side effects</a> include <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000306496/" class="def">diarrhea</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000390302/" class="def">nausea</a>, and itching.</p><p id="CDR0000062965__270">See <a href="http://www.cancer.gov/about-cancer/treatment/drugs/prostate" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Drugs Approved for Prostate Cancer</a> for more information.</p></div><div id="CDR0000062965__272"><h4>Chemotherapy</h4><p id="CDR0000062965__274"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">Chemotherapy</a> is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044678/" class="def">injected</a> into a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000476471/" class="def">vein</a> or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000301626/" class="def">systemic chemotherapy</a>). When chemotherapy is placed directly into the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046483/" class="def">cerebrospinal fluid</a>, an <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000257523/" class="def">organ</a>, or a body <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000463703/" class="def">cavity</a> such as the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045070/" class="def">abdomen</a>, the drugs mainly affect cancer cells in those areas (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046559/" class="def">regional chemotherapy</a>). The way the chemotherapy is given depends on the type and stage of the cancer being treated.</p><p id="CDR0000062965__275">See <a href="http://www.cancer.gov/about-cancer/treatment/drugs/prostate" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Drugs Approved for Prostate Cancer</a> for more information.</p></div><div id="CDR0000062965__277"><h4>Biologic therapy</h4><p id="CDR0000062965__279"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045617/" class="def">Biologic therapy</a> is a treatment that uses the patient’s <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046356/" class="def">immune system</a> to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body’s natural defenses against cancer. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000579628/" class="def">Sipuleucel-T</a> is a type of biologic therapy used to treat prostate cancer that has <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046283/" class="def">metastasized</a> (spread to other parts of the body).</p><p id="CDR0000062965__281">See <a href="http://www.cancer.gov/about-cancer/treatment/drugs/prostate" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Drugs Approved for Prostate Cancer</a> for more information.</p></div><div id="CDR0000062965__303"><h4>Bisphosphonate therapy</h4><p id="CDR0000062965__305"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044817/" class="def">Bisphosphonate</a> drugs, such as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045405/" class="def">clodronate</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045500/" class="def">zoledronate</a>, reduce bone disease when cancer has spread to the bone. Men who are treated with antiandrogen therapy or orchiectomy are at an increased risk of bone loss. In these men, bisphosphonate drugs lessen the risk of bone fracture (breaks). The use of bisphosphonate drugs to prevent or slow the growth of bone <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046710/" class="def">metastases</a> is being studied in clinical trials.</p></div></div><div id="CDR0000062965__316"><h3>There are treatments for bone pain caused by bone metastases or hormone therapy.
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</h3><p id="CDR0000062965__318">Prostate cancer that has spread to the bone and certain types of hormone therapy can weaken bones and lead to bone pain. Treatments for bone pain include the following: </p><ul id="CDR0000062965__319"><li class="half_rhythm"><div>Pain <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000482419/" class="def">medicine</a>.</div></li><li class="half_rhythm"><div>External radiation therapy.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045999/" class="def">Strontium-89</a> (a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045856/" class="def">radioisotope</a>).</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270742/" class="def">Targeted therapy</a> with a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046066/" class="def">monoclonal antibody</a>, such as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000514443/" class="def">denosumab</a>.</div></li><li class="half_rhythm"><div>Bisphosphonate therapy.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045658/" class="def">Corticosteroids</a>.</div></li></ul><p id="CDR0000062965__321"> See the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044271/" class="def">PDQ</a> summary on <a href="/books/n/pdqcis/CDR0000062845/">Pain</a> for more information. </p></div><div id="CDR0000062965__169"><h3>New types of treatment are being tested in clinical
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trials.</h3><p id="CDR0000062965__235">This summary section describes treatments that are being studied in clinical trials. It may not mention every new treatment being studied. Information about clinical trials is available from the <a href="http://www.cancer.gov/about-cancer/treatment/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI website</a>.</p><div id="CDR0000062965__171"><h4>Cryosurgery</h4><p id="CDR0000062965__173"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045407/" class="def">Cryosurgery</a> is a treatment that uses an instrument to freeze and destroy prostate cancer cells. Ultrasound is used to find the area that will be treated. This type of treatment is also called cryotherapy.</p><p id="CDR0000062965__238">Cryosurgery can cause impotence and leakage of urine from the bladder or stool from the rectum.</p></div><div id="CDR0000062965__215"><h4>High-intensity focused ultrasound</h4><p id="CDR0000062965__217"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000599983/" class="def">High-intensity focused ultrasound</a> is a treatment that uses ultrasound (high-energy sound waves) to destroy cancer cells. To treat prostate cancer, an <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000357580/" class="def">endorectal</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000367430/" class="def">probe</a> is used to make the sound waves.</p></div><div id="CDR0000062965__257"><h4>Proton beam radiation therapy</h4><p id="CDR0000062965__259"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270726/" class="def">Proton beam radiation therapy</a> is a type of high-energy, external radiation therapy that targets tumors with streams of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044715/" class="def">protons</a> (small, positively charged particles). This type of radiation therapy is being studied in the treatment of prostate cancer.</p></div></div><div id="CDR0000062965__248"><h3>Patients may want to think about taking part in a clinical trial.</h3><p id="CDR0000062965__248_23">For some patients, taking part in a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trial</a> may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044930/" class="def">standard treatment</a>.</p><p id="CDR0000062965__248_24">Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.</p><p id="CDR0000062965__248_25">Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.</p></div><div id="CDR0000062965__250"><h3>Patients can enter clinical trials before, during, or after starting their cancer treatment.</h3><p id="CDR0000062965__250_29">Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046556/" class="def">recurring</a> (coming back) or reduce the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046580/" class="def">side effects</a> of cancer treatment.</p><p id="CDR0000062965__250_30">Clinical trials are taking place in many parts of the country. See the Treatment Options section that follows for links to current treatment clinical trials. These have been retrieved from <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044267/" class="def">NCI's</a> listing of clinical trials. </p></div><div id="CDR0000062965__252"><h3>Follow-up tests may be needed.</h3><p id="CDR0000062965__252_33">Some of the tests that were done to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046450/" class="def">diagnose</a> the cancer or to find out the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045885/" class="def">stage</a> of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests.</p><p id="CDR0000062965__252_34">Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651193/" class="def">condition</a> has changed or if the cancer has <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046556/" class="def">recurred</a> (come back). These tests are sometimes called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044671/" class="def">follow-up</a> tests or check-ups.</p></div></div><div id="CDR0000062965__182"><h2 id="_CDR0000062965__182_">Treatment Options by Stage </h2><div id="CDR0000062965__183"><h3>Stage I Prostate Cancer</h3><p id="CDR0000062965__184"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044930/" class="def">Standard treatment</a> of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045129/" class="def">stage I prostate
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cancer</a> may include the following:</p><ul id="CDR0000062965__185"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045942/" class="def">Watchful
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waiting</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000616060/" class="def">Active surveillance</a>. If the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> begins to grow, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045110/" class="def">hormone
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therapy</a> may be given.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046549/" class="def">Radical
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prostatectomy</a>, usually with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045087/" class="def">pelvic</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045763/" class="def">lymphadenectomy</a>. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">Radiation therapy</a> may be given after
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">surgery</a>. </div></li><li class="half_rhythm"><div>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046751/" class="def">External-beam radiation
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therapy</a>. Hormone therapy may be given after radiation therapy.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046345/" class="def">Internal radiation therapy</a> with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000257219/" class="def">radioactive seeds</a>.</div></li><li class="half_rhythm"><div>A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trial</a> of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000599983/" class="def">high-intensity focused ultrasound</a>.</div></li><li class="half_rhythm"><div>A clinical trial of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045407/" class="def">cryosurgery</a>.</div></li></ul><p id="CDR0000062965__TrialSearch_183_10">Check the list of NCI-supported cancer clinical trials that are now accepting patients with <a href="http://www.cancer.gov/search/ClinicalTrialsLink.aspx?Diagnosis=38783&tt=1&format=1" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">stage I prostate cancer</a>. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the <a href="http://www.cancer.gov/about-cancer/treatment/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI website</a>.</p></div><div id="CDR0000062965__187"><h3>Stage II Prostate Cancer</h3><p id="CDR0000062965__188"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044930/" class="def">Standard treatment</a> of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045130/" class="def">stage II prostate
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cancer</a> may include the following:</p><ul id="CDR0000062965__189"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045942/" class="def">Watchful waiting</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000616060/" class="def">Active surveillance</a>. If the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> begins to grow, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045110/" class="def">hormone
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therapy</a> may be given.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046549/" class="def">Radical prostatectomy</a>, usually with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000322876/" class="def">pelvic lymphadenectomy</a>.
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">Radiation therapy</a> may be given after <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">surgery</a>. </div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046751/" class="def">External-beam radiation therapy</a>. Hormone therapy may be given after radiation therapy.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046345/" class="def">Internal radiation therapy</a> with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000257219/" class="def">radioactive seeds</a>.</div></li><li class="half_rhythm"><div>A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trial</a> of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045407/" class="def">cryosurgery</a>.</div></li><li class="half_rhythm"><div>A clinical trial of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000599983/" class="def">high-intensity focused ultrasound</a>.</div></li><li class="half_rhythm"><div>A clinical trial of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270726/" class="def">proton beam radiation therapy</a>.</div></li><li class="half_rhythm"><div>Clinical trials of new types of treatment, such as hormone therapy followed by radical prostatectomy.</div></li></ul><p id="CDR0000062965__TrialSearch_187_10">Check the list of NCI-supported cancer clinical trials that are now accepting patients with <a href="http://www.cancer.gov/search/ClinicalTrialsLink.aspx?Diagnosis=38784&tt=1&format=1" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">stage II prostate cancer</a>. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the <a href="http://www.cancer.gov/about-cancer/treatment/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI website</a>.</p></div><div id="CDR0000062965__191"><h3>Stage III Prostate Cancer</h3><p id="CDR0000062965__192"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044930/" class="def">Standard treatment</a> of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045131/" class="def">stage III prostate
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cancer</a> may include the following:</p><ul id="CDR0000062965__193"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046751/" class="def">External-beam radiation therapy</a>. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045110/" class="def">Hormone
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therapy</a> may be given after <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">radiation therapy</a>.</div></li><li class="half_rhythm"><div>Hormone therapy.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046549/" class="def">Radical prostatectomy</a>.
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Radiation therapy may be given after <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">surgery</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045942/" class="def">Watchful waiting</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000616060/" class="def">Active surveillance</a>. If the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> begins to grow, hormone
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therapy may be given.</div></li></ul><p id="CDR0000062965__295">Treatment to control cancer that is in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046539/" class="def">prostate</a> and lessen <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044093/" class="def">urinary</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045022/" class="def">symptoms</a> may include the following:</p><ul id="CDR0000062965__296"><li class="half_rhythm"><div>External-beam radiation therapy.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046345/" class="def">Internal radiation therapy</a> with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000257219/" class="def">radioactive seeds</a>.</div></li><li class="half_rhythm"><div>Hormone therapy.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045932/" class="def">Transurethral resection of the
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prostate</a> (TURP).</div></li><li class="half_rhythm"><div>A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trial</a> of new types of radiation therapy.</div></li><li class="half_rhythm"><div>A clinical trial of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045407/" class="def">cryosurgery</a>.</div></li></ul><p id="CDR0000062965__TrialSearch_191_10">Check the list of NCI-supported cancer clinical trials that are now accepting patients with <a href="http://www.cancer.gov/search/ClinicalTrialsLink.aspx?Diagnosis=38785&tt=1&format=1" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">stage III prostate cancer</a>. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the <a href="http://www.cancer.gov/about-cancer/treatment/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI website</a>.</p></div><div id="CDR0000062965__195"><h3>Stage IV Prostate Cancer</h3><p id="CDR0000062965__196"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044930/" class="def">Standard treatment</a> of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045132/" class="def">stage IV prostate
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cancer</a> may include the following:</p><ul id="CDR0000062965__197"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045110/" class="def">Hormone therapy</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044817/" class="def">Bisphosphonate</a> therapy.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046751/" class="def">External-beam radiation therapy</a>. Hormone therapy may be given after <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">radiation therapy</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000759898/" class="def">Alpha emitter radiation therapy</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045942/" class="def">Watchful waiting</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000616060/" class="def">Active surveillance</a>. If the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> begins to grow, hormone
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therapy may be given.</div></li><li class="half_rhythm"><div>A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trial</a> of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046549/" class="def">radical prostatectomy</a> with
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045441/" class="def">orchiectomy</a>.</div></li><li class="half_rhythm"><div>A clinical trial of hormone therapy combined with chemotherapy.</div></li></ul><p id="CDR0000062965__297">Treatment to control cancer that is in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046539/" class="def">prostate</a> and lessen <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044093/" class="def">urinary</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045022/" class="def">symptoms</a> may include the following:</p><ul id="CDR0000062965__298"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045932/" class="def">Transurethral resection of the
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prostate</a> (TURP).</div></li><li class="half_rhythm"><div>Radiation therapy.</div></li></ul><p id="CDR0000062965__TrialSearch_195_10">Check the list of NCI-supported cancer clinical trials that are now accepting patients with <a href="http://www.cancer.gov/search/ClinicalTrialsLink.aspx?Diagnosis=38786&tt=1&format=1" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">stage IV prostate cancer</a>. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the <a href="http://www.cancer.gov/about-cancer/treatment/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI website</a>.</p></div></div><div id="CDR0000062965__199"><h2 id="_CDR0000062965__199_">Treatment Options for Recurrent Prostate Cancer</h2><p id="CDR0000062965__200"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044930/" class="def">Standard treatment</a> of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045862/" class="def">recurrent</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000445079/" class="def">prostate cancer</a> may include the following:</p><ul id="CDR0000062965__201"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045110/" class="def">Hormone
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therapy</a>. </div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">Chemotherapy</a> for patients already treated with hormone therapy.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045617/" class="def">Biologic therapy</a> with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000579628/" class="def">sipuleucel-T</a> for patients already treated with hormone therapy.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046751/" class="def">External-beam radiation therapy</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045851/" class="def">Prostatectomy</a> for
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patients already treated with radiation therapy.</div></li><li class="half_rhythm"><div>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000759898/" class="def">Alpha emitter radiation therapy</a>.</div></li></ul><p id="CDR0000062965__TrialSearch_199_10">Check the list of NCI-supported cancer clinical trials that are now accepting patients with <a href="http://www.cancer.gov/search/ClinicalTrialsLink.aspx?Diagnosis=38787&tt=1&format=1" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">recurrent prostate cancer</a>. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the <a href="http://www.cancer.gov/about-cancer/treatment/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI website</a>.</p></div><div id="CDR0000062965__230"><h2 id="_CDR0000062965__230_">To Learn More About Prostate Cancer</h2><p id="CDR0000062965__231">For more information from the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044266/" class="def">National Cancer Institute</a> about prostate cancer, see the following:</p><ul id="CDR0000062965__271"><li class="half_rhythm"><div><a href="http://www.cancer.gov/types/prostate" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Prostate Cancer Home Page</a></div></li><li class="half_rhythm"><div><a href="http://www.cancer.gov/publications/patient-education/wyntk-prostate-cancer" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">What You Need to Know About™ Prostate Cancer</a></div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/CDR0000719565/">Prostate Cancer, Nutrition, and Dietary Supplements</a></div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/CDR0000062853/">Prostate Cancer Prevention</a></div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/CDR0000258032/">Prostate Cancer Screening</a></div></li><li class="half_rhythm"><div><a href="http://www.cancer.gov/about-cancer/treatment/drugs/prostate" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Drugs Approved for Prostate Cancer</a></div></li><li class="half_rhythm"><div><a href="http://www.cancer.gov/types/prostate/psa-fact-sheet" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Prostate-Specific Antigen (PSA) Test</a></div></li><li class="half_rhythm"><div><a href="http://www.cancer.gov/types/prostate/prostate-hormone-therapy-fact-sheet" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Hormone Therapy for Prostate Cancer</a></div></li><li class="half_rhythm"><div><a href="http://www.cancer.gov/publications/patient-education/understanding-prostate-cancer-treatment" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Treatment Choices for Men with Early-Stage Prostate Cancer</a></div></li><li class="half_rhythm"><div><a href="http://www.cancer.gov/about-cancer/treatment/types/surgery/cryosurgery-fact-sheet" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Cryosurgery in Cancer Treatment: Questions and Answers</a></div></li></ul><p id="CDR0000062965__230_40">For general <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> information and other resources from the National Cancer Institute, see the following:</p><ul id="CDR0000062965__230_41"><li class="half_rhythm"><div><a href="http://www.cancer.gov/about-cancer/diagnosis-staging/staging/staging-fact-sheet" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Cancer Staging</a></div></li><li class="half_rhythm"><div><a href="http://www.cancer.gov/publications/patient-education/chemo-and-you" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Chemotherapy and You: Support for People With Cancer</a></div></li><li class="half_rhythm"><div><a href="http://www.cancer.gov/publications/patient-education/radiation-therapy-and-you" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Radiation Therapy and You: Support for People With Cancer</a></div></li><li class="half_rhythm"><div><a href="http://www.cancer.gov/about-cancer/coping" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Coping with Cancer</a></div></li><li class="half_rhythm"><div><a href="http://www.cancer.gov/about-cancer/coping/questions" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Questions to Ask Your Doctor about Cancer</a></div></li><li class="half_rhythm"><div><a href="http://cancercontrol.cancer.gov/ocs/resources/survivors.html" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">For Survivors and Caregivers</a>
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</div></li></ul></div><div id="CDR0000062965__AboutThis_1"><h2 id="_CDR0000062965__AboutThis_1_">About This PDQ Summary</h2><div id="CDR0000062965__AboutThis_2"><h3>About PDQ</h3><p id="CDR0000062965__AboutThis_3">Physician Data Query (PDQ) is the National Cancer Institute's (NCI's) comprehensive cancer information database. The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries come in two versions. The health professional versions have detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions have cancer information that is accurate and up to date and most versions are also available in <a href="http://www.cancer.gov/espanol/publicaciones/pdq" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Spanish</a>.</p><p id="CDR0000062965__AboutThis_4">PDQ is a service of the NCI. The NCI is part of the National Institutes of Health (NIH). NIH is the federal government’s center of biomedical research. The PDQ summaries are based on an independent review of the medical literature. They are not policy statements of the NCI or the NIH.</p></div><div id="CDR0000062965__AboutThis_5"><h3>Purpose of This Summary</h3><p id="CDR0000062965__AboutThis_6">This PDQ cancer information summary has current information about the treatment of prostate cancer. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.</p></div><div id="CDR0000062965__AboutThis_7"><h3>Reviewers and Updates</h3><p id="CDR0000062965__AboutThis_8">Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Date Last Modified") is the date of the most recent change.
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</p><p id="CDR0000062965__AboutThis_9">The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the <a href="http://www.cancer.gov/publications/pdq/editorial-boards/adult-treatment" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">PDQ Adult Treatment Editorial Board</a>.
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</p></div><div id="CDR0000062965__AboutThis_10"><h3>Clinical Trial Information</h3><p id="CDR0000062965__AboutThis_11">A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
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</p><p id="CDR0000062965__AboutThis_12">Clinical trials are listed in PDQ and can be found online at <a href="http://www.cancer.gov/about-cancer/treatment/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI's website</a>. Many cancer doctors who take part in clinical trials are also listed in PDQ. For more information, call the Cancer Information Service 1-800-4-CANCER (1-800-422-6237).
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</p></div><div id="CDR0000062965__AboutThis_13"><h3>Permission to Use This Summary</h3><p id="CDR0000062965__AboutThis_14">PDQ is a registered trademark. The content of PDQ documents can be used freely as text. It cannot be identified as an NCI PDQ cancer information summary unless the whole summary is shown and it is updated regularly. However, a user would be allowed to write a sentence such as “NCI’s PDQ cancer information summary about breast cancer prevention states the risks in the following way: [include excerpt from the summary].”
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</p><p id="CDR0000062965__AboutThis_15">The best way to cite this PDQ summary is:</p><p id="CDR0000062965__AboutThis_21">National Cancer Institute: PDQ® Prostate Cancer Treatment. Bethesda, MD: National Cancer Institute. Date last modified <MM/DD/YYYY>. Available at: <a href="http://www.cancer.gov/types/prostate/patient/prostate-treatment-pdq" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">http://www.cancer.gov/types/prostate/patient/prostate-treatment-pdq</a>. Accessed <MM/DD/YYYY>.</p><p id="CDR0000062965__AboutThis_16">Images in this summary are used with permission of the author(s), artist, and/or publisher for use in the PDQ summaries only. If you want to use an image from a PDQ summary and you are not using the whole summary, you must get permission from the owner. It cannot be given by the National Cancer Institute. Information about using the images in this summary, along with many other images related to cancer can be found in <a href="http://visualsonline.cancer.gov/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Visuals Online</a>. Visuals Online is a collection of more than 2,000 scientific images.
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<div xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Views</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="PDF_download" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="/books/NBK65915.1/?report=reader">PubReader</a></li><li><a href="/books/NBK65915.1/?report=printable">Print View</a></li><li><a data-jig="ncbidialog" href="#_ncbi_dlg_citbx_NBK65915" data-jigconfig="width:400,modal:true">Cite this Page</a><div id="_ncbi_dlg_citbx_NBK65915" style="display:none" title="Cite this Page"><div class="bk_tt">PDQ Adult Treatment Editorial Board. Prostate Cancer Treatment (PDQ®): Patient Version. 2015 Jul 31. In: PDQ Cancer Information Summaries [Internet]. Bethesda (MD): National Cancer Institute (US); 2002-. <span class="bk_cite_avail"></span></div></div></li><li><a href="#" class="toggle-glossary-link" title="Enable/disable links to the glossary">Disable Glossary Links</a></li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Version History</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter shutter_closed" title="Show/hide content" remembercollapsed="true" pgsec_name="version_history" id="Shutter"></a></div><div class="portlet_content" style="display: none;"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><span class="bk_col_itm"><a href="/books/NBK65915.19/">NBK65915.19</a></span> December 20, 2024</li><li><span class="bk_col_itm"><a href="/books/NBK65915.18/">NBK65915.18</a></span> February 16, 2023</li><li><span class="bk_col_itm"><a 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xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="#CDR0000062965__102" ref="log$=inpage&link_id=inpage">General Information About Prostate Cancer</a></li><li><a href="#CDR0000062965__120" ref="log$=inpage&link_id=inpage">Stages of Prostate Cancer</a></li><li><a href="#CDR0000062965__140" ref="log$=inpage&link_id=inpage">Recurrent Prostate Cancer</a></li><li><a href="#CDR0000062965__142" ref="log$=inpage&link_id=inpage">Treatment Option Overview</a></li><li><a href="#CDR0000062965__182" ref="log$=inpage&link_id=inpage">Treatment Options by Stage </a></li><li><a href="#CDR0000062965__199" ref="log$=inpage&link_id=inpage">Treatment Options for Recurrent Prostate Cancer</a></li><li><a href="#CDR0000062965__230" ref="log$=inpage&link_id=inpage">To Learn More About Prostate Cancer</a></li><li><a href="#CDR0000062965__AboutThis_1" ref="log$=inpage&link_id=inpage">About This PDQ Summary</a></li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Related publications</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="document-links" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="/books/NBK66036/">Health Professional Version</a></li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Similar articles in PubMed</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="PBooksDiscovery_RA" id="Shutter"></a></div><div class="portlet_content"><ul><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/26389306" ref="ordinalpos=1&linkpos=1&log$=relatedreviews&logdbfrom=pubmed"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Prostate Cancer Screening (PDQ®): Patient Version.</a><span class="source">[PDQ Cancer Information Summari...]</span><div class="brieflinkpop offscreen_noflow"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Prostate Cancer Screening (PDQ®): Patient Version.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">PDQ Screening and Prevention Editorial Board. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">PDQ Cancer Information Summaries. 2002</em></div></div></li><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/26389388" ref="ordinalpos=1&linkpos=2&log$=relatedreviews&logdbfrom=pubmed"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Melanoma Treatment (PDQ®): Patient Version.</a><span class="source">[PDQ Cancer Information Summari...]</span><div class="brieflinkpop offscreen_noflow"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Melanoma Treatment (PDQ®): Patient Version.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">PDQ Adult Treatment Editorial Board. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">PDQ Cancer Information Summaries. 2002</em></div></div></li><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/26389278" ref="ordinalpos=1&linkpos=3&log$=relatedreviews&logdbfrom=pubmed"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Neuroblastoma Treatment (PDQ®): Patient Version.</a><span class="source">[PDQ Cancer Information Summari...]</span><div class="brieflinkpop offscreen_noflow"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Neuroblastoma Treatment (PDQ®): Patient Version.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">PDQ Pediatric Treatment Editorial Board. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">PDQ Cancer Information Summaries. 2002</em></div></div></li><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/26389197" ref="ordinalpos=1&linkpos=4&log$=relatedreviews&logdbfrom=pubmed"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Retinoblastoma Treatment (PDQ®): Patient Version.</a><span class="source">[PDQ Cancer Information Summari...]</span><div class="brieflinkpop offscreen_noflow"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Retinoblastoma Treatment (PDQ®): Patient Version.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">PDQ Pediatric Treatment Editorial Board. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">PDQ Cancer Information Summaries. 2002</em></div></div></li><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/26389322" ref="ordinalpos=1&linkpos=5&log$=relatedreviews&logdbfrom=pubmed"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Cancer Pain (PDQ®): Patient Version.</a><span class="source">[PDQ Cancer Information Summari...]</span><div class="brieflinkpop offscreen_noflow"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Cancer Pain (PDQ®): Patient Version.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">PDQ Supportive and Palliative Care Editorial Board. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">PDQ Cancer Information 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