What are the medications for prostate cancer?

Medications for prostate cancer

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Doctors usually recommend medications for people whose prostate cancer spreads to other areas. They refer to this as metastatic, or advanced, prostate cancer.

The National Cancer Institute (NCI) lists many different types of medications doctors regularly prescribe for people with prostate cancer. Examples include:

Other medications approved for prostate cancer include:

• zoledronic acid (Zometa)
• triptorelin (Trelstar)
• relugolix (Orgovyx)
• estramustine (Emcyt)
• leuprolide acetate (Eligard)
• olaparib (Lynparza)

Types of medical treatments

Most people with prostate cancer discover it early before it causes any issues.

Doctors may recommend postponing treatment until the cancer progresses, or they may suggest that the person takes medication immediately.

Some of the different treatments are as follows.

Hormone therapy

Prostate cancer cells need testosterone to grow.

Hormone therapy works by stopping the person’s body from producing testosterone or blocking it from the cancer cells. Male hormones are called androgens, and this treatment is also known as androgen deprivation therapy.

Medications that stop the person’s body from producing androgens include:

• leuprolide acetate (Eligard)
• triptorelin (Trelstar)
• abiraterone (Zytiga)

Medications that block prostate cancer cells are known as antiandrogens. These work by blocking the androgen receptors in the prostate cancer cells.

Without androgens, the cancer cells cannot grow. Examples of these medications include flutamide (Eulexin) and nilutamide (Nilandron).

Chemotherapy

Doctors may recommend chemotherapy if hormone therapy is not working or the cancer has spread beyond the prostate. Doctors deliver chemotherapy medications either in tablet form or via IV.

Chemotherapy medications interfere with the way the cancer cells grow, and may slow down their life cycle. While this probably will not cure a person’s prostate cancer, it can improve their quality of life and enable them to live longer.

Doctors often prescribe docetaxel (Taxotere) IV as the first chemotherapy medication. If this does not achieve the desired result, they may suggest cabazitaxel (Jevtana), also by IV.

Chemotherapy medications for prostate cancer in an oral tablet form include estramustine (Emcyt).

Targeted therapy

Targeted therapies interfere with the proteins that control how cancer cells grow, multiply, and spread. Doctors may recommend it for people who have a mutation in one of the BRAC genes.

These medications include rucaparib (Rubraca) and olaparib (Lynparza), which people take in tablet form.

Immunotherapy

Immunotherapy is a biologic therapy that uses medications to boost the body’s own immune response to cancer cells.

With sipuleucel-T (Provenge), doctors collect some immune cells from the person they are treating and mix them with a protein from the prostate cancer cells called prostatic acid phosphatase (PAP).

This infusion makes a vaccine unique to each person that stimulates their immune system to attack the cancer cells.

Doctors give 3 doses of the vaccine, each 2 weeks apart.

Radiopharmaceuticals

Radiopharmaceuticals are medications that contain some radioactive elements. Doctors inject them into the person’s body.

Doctors usually prescribe these if a person’s prostate cancer has spread to other body parts. They can also prescribe them if the cancer has not moved out of the prostate.

Lutetium Lu 177 vipivotide tetraxetan (Pluvicto) works if the person’s prostate cancer has a specific protein called prostate-specific membrane antigen (PSMA).

Doctors prescribe this medication in up to 6 doses, with each injection up to 6 weeks apart.

Doctors may prescribe other radiopharmaceuticals if the prostate cancer has spread to the person’s bones. These include radium-223 (Xofigo) and strontium-89 (Mestastron).

Bone-modifying drugs

According to the NCI, one of the side effects of antiandrogen hormone therapy is a risk of bone loss.

To help keep the bones healthy, doctors may prescribe IV bisphosphonates, such as zoledronic acid (Zometa) and clodronate (Bonefos).

Side effects

Many cancer treatments cause some unpleasant side effects, but doctors can recommend therapies to reduce these.

It is advisable for people to discuss potential side effects and ways to minimize them with a doctor before starting treatments.

Most people experience constipation, nausea, and fatigue as side effects of their treatments. People having chemotherapy may also experience hair loss, mouth sores, and an increased risk of contracting other infections.

People receiving hormone therapy sometimes have hot flashes, testicle shrinkage, and loss of sexual desire.

Doctors can usually recommend treatments to counteract these issues. The NCI notes that many people benefit from alternative treatments, including acupuncture and meditation.

Mental health support

Not all side effects are physical, and some people undergoing prostate cancer treatment may feel anxious or depressed. Doctors can recommend counseling, and additional medications, to help people overcome these feelings.

Frequently asked questions

This section answers common questions about prostate cancer medications.

Are there any medications that can cause prostate cancer?

In 2018, the Food and Drug Administration (FDA) warned that, although the risk was small, people taking 5-alpha reductase inhibitor (5-ARI) may develop an aggressive form of prostate cancer.

5-ARIs include finasteride (Proscar) and dutasteride (Avodart), which doctors prescribe for people with enlarged prostates or sometimes male pattern baldness.

However, the NCI also notes that people taking finasteride and dutasteride may have a lower risk of developing prostate cancer.

Can medications prevent prostate cancer?

The NCI says that some studies suggest taking finasteride (Proscar) or dutasteride (Avodart) may reduce the risk of a person developing prostate cancer.

However, the FDA warns that if a person does develop it while taking these, there is a slim chance that they will develop a more aggressive type.

The NCI also notes that most people taking these medications experience unwanted side effects, including reduced sexual desire and erectile dysfunction.

Summary

People with prostate cancer have various medications available to prolong and improve the quality of their lives. Different treatments work in different ways, and doctors may recommend them for different stages of prostate cancer.

While all medications can have potential side effects, not everyone experiences these, and doctors can often prescribe remedies to alleviate symptoms.