Prostate Knowledge Archive

Androgen deprivation therapy can slow or control prostate cancer, and adding a second class of drugs improves survival when the disease is in advanced stages. But all drugs that block testosterone have challenging side effects, and a review of studies showed that cardiovascular risks worsen when these drugs are given together.

When cancer patients are treated with radiation, it's possible that the therapy itself may cause new tumors to form in the body later. Canadian researchers published findings in 2014 finding no difference between groups of men treated with cancer or with surgery — but following up another decade later, there was a clear increase in risk.

Active surveillance (AS) is the most common choice for men facing a diagnosis of low-risk prostate cancer, in which the tumor is confined to the prostate gland and unlikely to grow or spread. Men can potentially continue AS indefinitely until their condition changes. There are situations in which they should move to treatment because the cancer has become more aggressive. Or they may be ready to stop if there has been no cancer progression or they no longer wish to continue with the regular monitoring and testing of AS.

When a PSA test produces an abnormal result, the next step is usually a prostate biopsy, but these have drawbacks. Researchers are exploring strategies to avoid unnecessary biopsies, and a test that screens for prostate cancer in urine samples has shown promising results in testing.

A 2023 study confirms prior research showing that men with low testosterone levels who use testosterone replacement therapy for 14 months are not at a higher risk for prostate cancer over the following several years.

Minimally invasive surgery to remove the prostate gland is generally very well tolerated, but there can be complications, as in the case of Defense Secretary Lloyd Austin earlier this year. A Harvard-affiliated urologist answers questions about the possibility of such complications.

Infections after a prostate biopsy are rare, but they do occur. There are two ways to perform such a biopsy, with the one at higher risk of infection more common in the US. Researchers conducted a trial designed to compare the safety of the two methods.

Men with advanced prostate cancer are typically treated with hormonal treatments followed by chemotherapy, but a recent study evaluated the potential of a treatment that uses radioactive particles injected into the body.

When prostate cancer recurs after initial treatment, doctors typically treat it with hormonal therapies. But results from a large clinical trial show that a different medication (or combination of two medications) is a better approach.

Many men diagnosed with low-grade prostate cancer follow active surveillance, in which they regularly follow up with a doctor for routine PSA tests, prostate biopsies, and possibly MRI scans. If there is evidence their cancer has progressed, then they can consider treatment (radiation or surgery). While there is little men can do to slow the growth of known low-grade prostate cancer, losing excess weight and keeping it off may help keep undetected high- or medium-grade cancer from becoming more aggressive.