Prostate Cancer Treatment (PDQ®)–Health Professional Version

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Changes to This Summary (08/09/2018)

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.

General Information About Prostate Cancer

The Diagnostic Evaluation subsection was extensively revised.

Treatment Option Overview for Prostate Cancer

Added text to the complications of radical prostatectomy list to include functional outcomes with respect to sexual, urinary, bowel function, and health-related quality of life, which appear to be similar whether the procedure is open retropubic, laparoscopic, or robot-assisted radical prostatectomy (cited Nossiter et al. as reference 58).

Added Michalski et al. as reference 68 and level of evidence 1iiDiii).

Added text about statistics from the RTOG-0126 trial of 1,532 men with stage cT1b to T2b prostate cancer who were randomly assigned to receive external-beam radiation therapy, the doses given, and the median overall survival (OS) rates. Also added that high-dose radiation was associated with increased late-grade 2 or greater gastrointestinal and genitourinary toxicities.

Added Photodynamic therapy as a new subsection.

Stage I Prostate Cancer Treatment

Added Photodynamic therapy as a new subsection.

Stage II Prostate Cancer Treatment

Added Photodynamic therapy as a new subsection.

Stage IV Prostate Cancer Treatment

Added Kyriakopoulos et al. as reference 43.

Added text to state that patients in the CHAARTED trial were prospectively stratified as having a high- versus low-volume disease, with high volume defined as the presence of visceral metastases or at least four bone lesions, with at least one lying outside the vertebral column or pelvis; about 65% of patients had high-volume disease by this definition. Added statistics about the following: median OS, the survival advantage being observed only in patients with high-volume disease, and a comparison of the quality of life between the two study groups, as measured by the Functional Assessment of Cancer Therapy-Prostate scale (cited Morgans et al. as reference 44).

Recurrent or Hormone-Resistant Prostate Cancer Treatment

This section was renamed from Recurrent Prostate Cancer Treatment.

Added text to include apalutamide as a hormonal approach and a competitive inhibitor of the androgen receptor, which has been tested in the setting of clinically nonmetastatic, hormone-resistant prostate cancer. Also added statistics from a trial of 1,207 men who were randomly assigned in a 2:1 ratio to either daily apalutamide or placebo and continued on their previous androgen deprivation therapy (cited Smith et al. as reference 33 and level of evidence 1iDii). There was a trend toward improved OS in the apalutamide group, and there were increases in a number of toxicities associated with apalutamide treatment.

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.

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