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Advanced Prostate Cancer

Prostate cancer treatment is a very complex and involved process. The expert team at Urology Centers of Alabama’s Van Scott Cancer Center is dedicated to staying up-to-date with the latest emerging treatments and recommendations to ensure patients receive the greatest care available. In addition to treating the patient’s prostate cancer itself, the Urologic Cancer Center treats a patient on a global level by addressing the physical, nutritional, and emotional side effects that often coincide with strenuous cancer treatment.

Advanced Prostate Cancer Stages

Advanced prostate cancer is when prostate cancer spreads beyond the prostate or returns after treatment. Prostate cancer is typically grouped into four stages:

  • Stage I: The cancer is small, confined to the prostate and grows slowly.
  • Stage II: The cancer is still confined to the prostate but is more likely to spread.
  • Stage III: The cancer has spread beyond the prostate but not to the lymph nodes or other organs such as the bladder and rectum.
  • Stage IV:  The cancer has spread to nearby areas such as the bladder, rectum and lymph nodes, or to distant organs and even bones.


Immunotherapy uses the body’s immune system to combat the cancer. It is a great option for men who are experiencing little to no symptoms or only mild symptoms. If the cancer returns and spreads, your physician may recommend a therapeutic cancer vaccine to boost your immune system so it can better fight the cancer cells. Immunotherapy may be given to patients before chemotherapy or used alongside chemotherapy. Two of the immunotherapy options available to UCA patients are PROVENGE® and Xofigo®. PROVENGE® is an immunotherapy and the only personalized treatment that is clinically proven to help extend life in certain men with advanced prostate cancer. PROVENGE® immunotherapy takes your own immune cells and reprograms them to attack your advanced prostate cancer. Xofigo® is an immunotherapy treatment option that is used to treat prostate cancer that is resistant to medical or surgical treatments that lower testosterone and has spread to the bones with symptoms but not to other parts of your body. The medical term for this condition is metastatic castration-resistant prostate cancer or mCRPC. This radioactive particle is injected into the vein under the supervision of the radiation oncologist with the goal of the radioactive particle going specifically to the cancer in the bone.


Chemotherapy drugs can slow the growth of cancer, and potentially, reduce symptoms and extend life. Chemotherapy may also ease pain associated with the prostate cancer and associated symptoms by shrinking the size of the tumor. Chemotherapy is useful for patients whose cancer has spread to other parts of the body. Most chemotherapy drugs are administered by vein (intravenous, IV). During chemotherapy, the drugs move throughout the body. They kill quickly growing cancer cells and non-cancer cells. Often, chemotherapy is not the main therapy for prostate cancer, though it is a useful treatment for men whose cancer has spread and are still responding to hormone therapy.

Oral Oncolytics

Another option your doctor may recommend is taking oral oncolytics, a pill. Depending on the stage of the cancer and how early it is caught, oral oncolytics can help slow the cancer’s progression. Oral oncolytics can provide patients with many different benefits such as fewer trips to a medical facility, less time spent in treatment and fewer side effects. It’s also easier to stop the treatment if needed compared to alternative treatment options.

Additional Services We Offer

Bone Health

Bone health is a very important part of prostate cancer treatment for men on androgen deprivation therapy. The injections given to treat the cancer have an anti-testosterone effect, and low testosterone is a well-known cause of osteoporosis in men. The hormone therapy causes bone mineral density loss and increases fracture incidence; therefore, it is recommended that all men on hormone therapy be on a calcium and vitamin D supplement daily.

In addition to this, we recommend treatment with either Fosamax, Prolia, or Xgeva based on whether or not the cancer has spread to the bone. If there is bone metastasis, monthly injections of Xgeva are required for the first year and then every three months thereafter. If there is no spread to the bone, then patients can elect to either get an injection once every six months (Prolia), or take an oral medication once a week (Fosamax).


The emotional side of cancer is not discussed as often as the physical effects, but it is not something to be overlooked. Dealing with a cancer diagnosis can be difficult and stressful for patients and their families; therefore, Urology Centers of Alabama has established a referral relationship with Mr. Butch Williams to enable our patients to better cope with the disease. Mr. Williams is involved in pastoral care at Vestavia Hills United Methodist Church and is a prostate cancer survivor himself.

However, one does not have to be a particular denomination or even religious to benefit from this service. Sometimes it just helps to talk with someone who has undergone similar experiences. Mr. Williams serves as a compassionate presence and is there to offer comfort, not convert you to a particular religious belief. Studies show that your emotional well-being can affect your cancer treatment and progress. We want to ensure that not only are our patients’ physical needs being met, but their emotional and spiritual ones as well.


Studies show that one of the best ways to take care of yourself is to maintain an active lifestyle, and this is especially important for men with prostate cancer. One of the primary treatments for prostate cancer is hormone therapy which works by lowering a man’s testosterone level. Although this helps suppress the cancer, it puts men at risk for muscle mass and bone density loss and increases the risk of a cardiovascular event.

There are numerous benefits to physical activity. Not only does it help control weight and improve your cardiovascular health, but it also is beneficial for your bone health, energy, and mood. Urology Centers of Alabama is very excited to have partnered with the Shades Valley YMCA to address this issue. We have developed a fitness program aimed to improve the side effects of hormone therapy, and the Y is graciously allowing our patients to participate in this 12-week program free of charge.


Nutrition is also an important component to prostate cancer health. Unhealthy diets that are high in red meat, cheese, and sugar might be linked to higher risk of death from cancer. We are dedicated to seeing that our patients follow a well-balanced diet. We also know that prostate cancer patients have the potential to lose weight and become deficient in several nutrients as they go through this process. Therefore, we check complete metabolic profiles to make sure our patients are nutritionally sound. Based on these results, we might recommend supplements or prescription medications. We also have a nutritionist to whom we refer our patients if needed.

Genetic Testing