Combination Treatments for High-Risk Prostate Cancer
High-risk prostate cancer means that the cancer is more aggressive, and there is a higher chance that the cancer will spread to other parts of the body or recur. Surgery or radiation therapy are still effective, but more than one type of treatment may be required to give the patient the best chance of cure. If you are told that your cancer is in the unfavorable intermediate, high, or very high-risk group, make sure to talk to your doctor about your options for combination treatment.
| Surgery + Radiation Therapy | With or without hormone therapy. For men with high-risk prostate cancer that has spread into nearby areas, radiation therapy may be started 4–6 months post-surgery, even if the PSA has not risen. This is called adjuvant radiation therapy. It may reduce the risk of recurrence but may also increase the risk of side effects. Another strategy is to use radiation therapy only if PSA levels rise to 0.1 or 0.2 ng/mL; this is referred to as early salvage radiation therapy, which should be done soon after the first PSA becomes detectable. Hormone therapy may also be given concurrently. Your doctor can order a test of your tumor tissue from surgery, called the Decipher® Prostate RP test, to help guide these decisions. |
| Surgery + Hormone Therapy | Hormone therapy (with or without radiation therapy) may also be recommended for men who have cancer found in their lymph nodes at the time of surgery. |
| Radiation Therapy + Hormone Therapy | Hormone therapy has been shown to improve cure rates of prostate cancer for men receiving radiation therapy. It is part of the standard of care for men with unfavorable intermediate-risk prostate cancer and nearly all high-risk prostate cancer. It is often given for unfavorable intermediate-risk cancer for4–6 months and for 1.5–3 years in men with high-risk disease. |
| Brachytherapy + EBRT* + Hormone Therapy | Patients with unfavorable intermediate and high-risk prostate cancer may receive a combination of EBRT plus brachytherapy and should also receive the addition of hormone therapy. |
*EBRT, External Beam Radiation therapy
Another option to consider may be a clinical trial. These are research studies that evaluate the effectiveness and/or safety of new medical, surgical, or behavioral interventions or existing ones within new settings.
Last Reviewed: 12/2023
