ROYAL

Men with metastatic prostate cancer live substantially longer compared to men with metastases from other types of cancer. Royal subdivides into three categories: Low-Royal is present in men with hormone resistance (defined as a rising PSA while testosterone is low) but scans showing no metastases. Men with Basic-Royal have five or fewer metastases. Men with High-Royal have more than five metastases. The treatment will vary according to subtype. Frequent monitoring with PSA and scans is essential to confirm its effectiveness.  Treatment should be quickly changed if the initially selected therapy becomes ineffective.

Men in Royal category who have never had hormone therapy should start with Lupron plus Zytiga or Taxotere. In addition, patients who have five or fewer metastasis should consider radiation therapy aimed at the metastases. If the cancer becomes resistant to Lupron, the next step is to start Provenge, which boosts the immune system. Other options to consider are Xofigo, a form of injectable radiation, Jevtana, another type of chemotherapy or a clinical trial using a new investigational agent

Physical strength and bone health play in important role in achieving good outcomes and maintaining a good quality of life.  Resistance training with weights under the supervision of a trainer to build strength is essential. For bone strength, unless there are medical contraindications, everyone in Royal should receive Xgeva or Zometa.

A whole section of The Key to Prostate Cancer is devoted to making treatment selection for Royal understandable.  Key also provides information about diet, exercise, general men’s health, supplements, biopsies, scans, as well as a chapter about how to recognize and select the best doctors.

A whole section of The Key to Prostate Cancer is devoted to making treatment selection for Royal understandable to patients.  Key also provides information about diet, exercise, general men’s health, supplements, biopsies, scans, as well as a chapter about how to recognize and select the best doctors.