Radium-223 Dichloride, otherwise known as Xofigo, is the first alpha-emitting radiopharmaceutical used to treat prostate-cancer-related bone metastasis. The FDA approved Xofigo in May of 2013. The clinical trial that led to the FDA approval was called the ALSYMPCA trial. Eligible patients were randomized in a 2:1 fashion to either receive six monthly intravenous injections of radium-223 or best standard of care, such as antiandrogen hormonal therapy, local external beam radiation, corticosteroids, estramustine, or ketoconazole. The men who received radium-223 had improvement in bone pain and also experienced an increased survival.

A new oral medication called ARAMIS is being evaluated in men who have rising PSA levels on Lupron and whose bone scans remain clear. For more information, visit: https://clinicaltrials.gov/show/NCT02200614

ARAMIS is similar to Xtandi but may have some advantages because ARAMIS is less likely to affect brain function which could reduce the likelihood of seizures and side effects...

"If you are looking about information about Prostate cancer for yourself or someone you love, you are going to encounter the Gleason Score. OK so what is it? At it’s simplest the Gleason score is a measure of how aggressive or nonaggressive a prostate cancer tumor is. 

The surprising finding, after 12 years, was that there was no difference in survival between surgery and watchful waiting in the Low-Risk or in the Intermediate-Risk group.  On the other hand, men who were in the High-Risk category did benefit with improved 12-year survival when treated with immediate surgery compared to the men with High-Risk disease who did watchful waiting.