Metastatic Prostate Cancer
Treatment recommendations for newly diagnosed and hormone-relapsed metastatic disease.
Newly Diagnosed Metastatic Cancer (1.5.1-1.5.5)
First-Line Treatment (1.5.1)
Offer people with newly diagnosed metastatic prostate cancer:
- • Hormone therapy AND
- • Docetaxel chemotherapy
Additional Options (1.5.4)
Consider offering:
- • Abiraterone with prednisolone OR
- • Enzalutamide
Important: Discuss risks and benefits of docetaxel chemotherapy with patients. Prescribing should follow NICE's guidance on prescribing medicines.
Hormone-Relapsed Metastatic Cancer (1.5.6-1.5.11)
Treatment Options (1.5.6)
Offer people with hormone-relapsed metastatic prostate cancer:
- • Abiraterone with prednisolone OR
- • Enzalutamide OR
- • Docetaxel chemotherapy
Further Options (1.5.9)
Consider offering:
- • Cabazitaxel with prednisolone OR
- • Radium-223 dichloride
Clinical Note: Treatment selection for hormone-relapsed disease should be individualized based on patient factors, prior treatments, and disease characteristics. Always discuss risks and benefits with the patient.
Treatment Summary
| Disease Status | Recommended Treatment |
|---|---|
| Newly Diagnosed Metastatic | Hormone therapy + Docetaxel |
| Newly Diagnosed (Alternative) | Consider: Abiraterone or Enzalutamide |
| Hormone-Relapsed | Abiraterone OR Enzalutamide OR Docetaxel |
| Hormone-Relapsed (Further) | Consider: Cabazitaxel or Radium-223 |
GP Role in Metastatic Disease
As a GP, your role includes:
- • Monitoring: Regular assessment of treatment tolerance and side effects
- • Support: Provide counseling and psychosocial support
- • Liaison: Maintain close communication with oncology services
- • Symptom Management: Address pain, fatigue, and other symptoms
- • Medication Management: Manage side effects of chemotherapy and hormone therapy
- • Palliative Care: Coordinate palliative and end-of-life care as appropriate
- • Family Support: Provide support to patients' families and carers