Recent advances in the medical management of prostate cancer.
Prostate cancer is a 20th century seedling which, because of its attendant morbidity and mortality and the increased longevity of the population, is set to germinate into a substantial economic burden in the next millennium. Most patients with prostatic cancer present with either locally advanced or metastatic disease, for which palliative endocrine therapies are the first-line treatment. The increasingly sophisticated and selective hormonal methods available today, such as the longer-acting formulations of luteinizing hormone-releasing hormone (LH-RH) analogues and newer, better-tolerated, once-daily, non-steroidal anti-androgens, have increased the therapeutic options and improved patient quality of life. Maximum androgen blockade, combining medical or surgical castration with an anti-androgen, is an increasingly accepted therapy, and offers the greatest efficacy, particularly for patients with a lesser disease burden. The development of hormone-refractory tumours is still a problem in advanced prostate cancer, although elucidation of the mechanisms involved should offer many potentially fruitful avenues for new therapies.
Kirby
R S
RS
Urology Department, St George's Hospital, London.
D018674:Adrenergic Antagonists / Q000627:therapeutic use*; D004358:Drug Therapy / Q000639:trends; D007987:Gonadotropin-Releasing Hormone / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D011471:Prostatic Neoplasms / Q000628:therapy*; D017211:Treatment Failure
D018674:Adrenergic Antagonists; D007987:Gonadotropin-Releasing Hormone