Advanced Prostate Cancer

Advanced prostate cancer is disease that has spread beyond the prostate gland to the lymph nodes, bones, or other areas and is referred to as metastatic. At The Mount Sinai Hospital, our multidisciplinary team of outstanding physicians offers the latest research-backed services for the diagnosis and treatment of advanced prostate cancer.

Advanced Prostate Cancer Treatments

The standard first line treatment for metastatic prostate cancer is hormonal therapy, also known as androgen ablation or endocrine therapy. Since male hormones (notably testosterone) fuel prostate cancer growth, cancer growth is slowed by limiting testosterone. Over time, most patients with advanced prostate cancer become resistant to hormonal therapy. The cancer is then referred to as castration-resistant.

When hormonal therapy fails, the next approach is usually chemotherapy. The chemotherapy drug docotaxel (Taxotere®), taken with or without a steroid, is the standard chemotherapy regimen for men who no longer respond to hormones. Cabazitaxel (Jevtana®) is another chemotherapeutic agent that is used in men with castration-resistant prostate cancer that has progressed during, or after, treatment with docotaxel.

In 2010, the FDA approved Provenge®, a vaccine for advanced prostate cancer. Provenge is an immunotherapeutic agent, which has demonstrated positive results. Simon J. Hall, MD, Director of the Barbara and Maurice Deane Prostate Health Center, was instrumental in the studies leading to the approval of the vaccine, and he is currently leading clinical trials investigating optimal dosing, long-term side effects, and its use in combination with other emerging agents for advanced disease.

Abiraterone (Zytiga®) was approved in 2011. It is an anti-androgen drug indicated to be used with prednisone after prostate cancer has progressed while receiving docotaxel. It can also be administered after completing a docotaxel regimen.

Therapeutics on the Horizon

Enzalutamide, formerly known as MDV3100, has recently been given priority review status for approval. In clinical trials, enzalutamide prolonged overall survival by about five months and reduced the risk of death by 37 percent in men with metastatic, castration-resistant prostate cancer.

A collaborative program between Dr. Hall; Matthew Galsky, MD, Director of Genitourinary Medical Oncology; and William Oh, MD, Chief of Hematology/Oncology, are developing novel treatment options and clinical trials to further advance the care of men with advanced prostate cancer.

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Robotic Prostate Cancer Surgery

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New York, New York 10022
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