Prostate cancer is the leading cause of malignancy among American men and the third leading cause of cancer deaths. Approximately 42% of men will progress following local definitive therapy, with either rising PSA or metastatic disease. Androgen-deprivation therapy (ADT) is the primary treatment for metastatic prostate cancer. Although it is increasingly used in different disease stages and patient populations, there is still controversy regarding its use in patients whose sole determinant of disease progression is rising PSA. Various treatment modalities have been studied in combination with ADT to determine their overall efficacy and benefit in terms of progression-free and overall survival, leading to the use of ADT in selected patient populations. However, ADT is not without side effects. Different dosing strategies, such as intermittent ADT and rapid hormonal cycling, are being employed to determine how to administer ADT for maximum benefit and minimal toxicity. For the many patients who will eventually develop incurable, often debilitating metastatic castrate-resistant disease, strategies for directing novel therapies at the androgen-receptor signaling pathway and apoptotic genes hold future promise. This chapter discusses the clinical applications, side effects, and overall effects of ADT, clinical studies that support or controvert its use in selected patient populations and stages of prostate cancer, and the biology of castrate-resistant prostate cancer and novel approaches to its treatment.
|Title of host publication
|Subtitle of host publication
|Production, Functions and Disorders
|Nova Science Publishers, Inc.
|Number of pages
|Published - Aug 2012
ASJC Scopus subject areas
- General Biochemistry, Genetics and Molecular Biology