Castration-Resistant Prostate Cancer Definition: What Is It?

Castration-resistant prostate cancer fits that definition when the level of prostate-specific antigen (PSA) keeps rising or new symptoms appear even after the cancer has been treated with radiation or surgery.

Castration refers to a level of testosterone in the body under 50 ng/dl after treatment, which is referred to as castrate level of testosterone, according to Cancer Network. In most prostate cancer patients, having a castrate level of testosterone stops the disease from progressing, but in some cases the PSA level continues to rise, which indicates that the disease is still progressing on some level. This is why it is referred to as castration-resistant.

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Metastatic cancer means that the cancer has spread beyond the original area to other parts of the body. Non-metastatic castration-resistant prostate cancer sometimes responds to androgen deprivation therapy, which keeps PSA levels in check for about 30 to 35 percent of patients, at least for a while.

Various treatments can prolong the life span and keep symptoms in check for a period of time, but unfortunately, most patients become resistant to these treatments eventually, and the disease progresses and becomes metastatic over a period of time.

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The National Institutes of Health states that bone metastases will occur in 90 percent of men with castration-resistant prostate cancer and that survival rates decline once this occurs. Prednisone is used with other treatments to decrease bone pain when metastases occur.

Clinical trials continue to test new treatments for castration-resistant prostate cancer, including drugs that inhibit the androgen receptor, which researchers feel might keep the disease from progressing if it is non-metastatic, according to UpToDate.

Prostate cancer is the second most common type of cancer in men across the world. More than 25 percent of all new cancer diagnoses for men in the United States are of prostate cancer, and it is the second leading cause of U.S. men’s cancer deaths, according to Cancer Network.

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