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Prostate Cancer Treatment (PDQ®)

Changes to This Summary (04/23/2015)

The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.

Treatment Option Overview for Prostate Cancer

Added Klotz et al. as reference 7.

Added text to state that in the aggregate, men managed by watchful waiting or active surveillance have had very favorable prostate–cancer-specific mortalities ranging from about 2% to 10%.

Added text to state that in a prospective single-center study, 993 men with favorable or intermediate-risk prostate cancer were followed with active surveillance, and definitive therapy was reserved for patients with evidence of clinical progression (added level of evidence 3iiiD); also added median follow-up and prostate–cancer-specific survival rates, and rates about the proportions of men who remained untreated.

Added text to state that radium-223 improved OS in patients with prostate cancer metastatic to bone in a double-blind, randomized, controlled trial of 921 men with symptomatic castration-resistant prostate cancer, two or more metastases, and no known visceral metastases. The men were randomly assigned in a 2:1 ratio to radium-223 versus placebo. Radium-223 statistically significantly improved OS, rate of symptomatic skeletal events, and spinal cord compression (cited Sartor et al. as reference 66 and level of evidence 1iA).

Added O'Farrell et al. as reference 87.

Recurrent Prostate Cancer Treatment

Revised text to state that abiraterone has mineralocorticoid effects, producing an increased incidence of fluid retention and edema, hypokalemia, hypertension, and cardiac dysfunction; abiraterone is associated with hepatotoxicity (cited Sternberg et al. as reference 18), but abiraterone toxicities are milder than those of other therapies.

Added text to state that median time to health-related quality-of-life deterioration was long in the abiraterone study arm, as assessed by the Functional Assessment of Cancer Therapy-Prostate Version 4 (FACT-P) total score and by the prostate–cancer-specific subscale (cited Basch et al. as reference 20 and levels of evidence 1iC).

Added Sartor et al. as reference 59.

Added text to state that the rates of symptomatic skeletal events and spinal cord compression were also statistically significantly improved.

Added text to state that with administration of radium-223 at a dose of 50kBq per kg of body weight every 4 weeks for six injections, the side effects were similar to those of a placebo.

This summary is written and maintained by the PDQ Adult Treatment Editorial Board, which is editorially independent of NCI. The summary reflects an independent review of the literature and does not represent a policy statement of NCI or NIH. More information about summary policies and the role of the PDQ Editorial Boards in maintaining the PDQ summaries can be found on the About This PDQ Summary and PDQ NCI's Comprehensive Cancer Database pages.

  • Updated: April 23, 2015