[Metastasis of prostatic cancer. Mechanisms and sites, therapeutic management and review of published results. Strategies of prevention of metastases during initial treatment].
Cancer of the prostate is the leading cause of death from cancer in men over 75 years of age, and the second cause in younger men. Metastases are present at the time of diagnosis in 40% of cases. The existence of growth factors and the role of male hormones, as well as the relationship between tumor cells and stroma now provide a clearer picture of why prostate cancer metastases have an affinity for bone and produce osteoblastic lesions. The treatment of these metastases depends primarily on the suppression of androgen activity which can be achieved at several levels. Although hormone therapy can influence the course of the tumor in 80% of cases, the objective response rate for first line therapy rarely exceeds 50%. In most cases, resistance to hormone therapy occurs in the first 18 months. In such cases chemotherapy can be expected to produce a 30-35% objective response rate. The modalities of hormone therapy (single agents or "complete hormonal blockade") and the role of chemotherapy are still controversial issues. Measures designed to avoid metastatic spread at the time of initial therapy are discussed.
Breau
J L
JL
Clinique de Cancérologie, CHU Avicenne, Bobigny.
D000368:Aged; D001859:Bone Neoplasms / Q000517:prevention & control / Q000556:secondary*; D003131:Combined Modality Therapy; D006801:Humans; D008207:Lymphatic Metastasis / Q000517:prevention & control; D008297:Male; D011471:Prostatic Neoplasms / Q000473:pathology* / Q000628:therapy
Métastases des cancers de la prostate. Mécanismes et sites, conduite thérapeutique et revue des résultats publiés. Stratégie de prévention des métastases lors du traitement initial.