Treatment of progressive metastatic prostate cancer.
The optimal therapy for metastatic prostate cancer that has failed initial hormonal therapy poses a significant dilemma for the attending physician. No salvage therapy has proven to be clearly superior. Currently accepted treatment options range from supportive care alone to highly investigational regimens. Recent encouraging results have been reported with investigational agents such as suramin and R. 75251 (Liarozole), and with novel combinations such as estramustine (Emcyt) plus vinblastine. However, there is still no proof that salvage therapy prolongs survival. In a patient population that is older and frequently debilitated, with an expected median survival of 6 months, determinants of therapy should include drug toxicity profiles, frequency of treatment and follow-up studies, and necessity for hospitalization. For patients with good performance status and organ function, participation in clinical trials should be advocated. Quality-of-life issues should be integrated into all clinical trials involving hormone-refractory metastatic prostate cancer.
Hematology-Oncology Service, Walter Reed Army Medical Center, Washington, DC.
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Dawson
D000726:Androgen Antagonists / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use; D015507:Drugs, Investigational / Q000627:therapeutic use; D006801:Humans; D008297:Male; D009362:Neoplasm Metastasis / Q000503:physiopathology*; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000503:physiopathology* / Q000532:radiotherapy
D000726:Androgen Antagonists; D000970:Antineoplastic Agents; D015507:Drugs, Investigational