Deciding Best Next Steps in Prostate Cancer Treatment

Here's how one expert decides on the next steps in treatment when a man with prostate cancer has a rising PSA and no visible metastases.

There is no standard protocol for treating men with prostate cancer who are on hormonal therapy and have a rising PSA, but no signs of metastasis.

When deciding on the next line of treatment, Matthew R. Cooperberg, M.D., M.P.H., associate professor and Epidemiology & Biostatistics Helen Diller Family Chair in Urology at UCSF, said that he looks at the details: What is the patient's Gleason score, prior treatments and other aggressive characteristics of the disease?

This group of patients will likely require more systemic treatment with novel agents. Patients and physicians should discuss risks, treatment side effects and the cancer's aggressiveness when deciding when it is the right time to start, says Cooperberg.