Management plan for post-chemotherapy, symptomatic patients with good performance status

(A) Clinical trial participation is recommended.

(B) Abiraterone given together with prednisolone is recommended as treatment. Abiraterone slows the production of testosterone to inhibit the growth of prostate cancer cells. Prednisolone is taken together to reduce the side effects of abiraterone.

(C) Ketoconazole given together with hydrocortisone is recommended upon increase of prostate-specific antigen (PSA). An increased level of PSA correlates with presence of prostate cancer cells. Ketoconazole is a drug that will inhibit the production of male sex hormones, thus inhibiting the growth of prostate cancer cells. Hydrocortisone is taken together to reduce the side effects of ketoconazole. Your doctor may continue to recommend the use of ketoconazole on the basis of lower cost.

(D) Enzalutamide treatment. Enzalutamide is a drug that prevents male sex hormones from stimulating prostate cancer cells to grow.

(E) Cabazitaxel treatment. Cabazitaxel belongs to a group of drugs known as taxanes that inhibit the growth of cancer cells.

(F) A repeat use of docetaxel. Docetaxel is an anti-cancer drug that inhibits cancer cell division.

(G) Radium-223 treatment. This is an option in patients who decline chemotherapy and do not have cancer that has spread to the internal organs.