title: Secondary hormonal therapy.
abstract: Almost all patients with metastatic prostate cancer will eventually develop hormone refractory disease. In general, these patients should be enrolled in a clinical trial designed to develop new therapies for the treatment of this disease. However, for a variety of reasons, some patients will not be candidates for these trials. In this setting, a secondary hormonal therapy is a viable option. Secondary hormonal therapy continues and extends the two basic approaches used in primary hormonal therapy: reduction in circulating androgens and competitive inhibition of androgen receptor binding. This article reviews the basic concepts of secondary hormonal therapy, including maintenance of testicular androgen suppression, the anti-androgen withdrawal syndrome, and the available agents. In addition, it reviews hormonal agents currently in development that act by other mechanisms to inhibit prostate cancer growth.
authors.affiliation: Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor, USA. dcsmith@umich.edu
authors.forename: D C
authors.initials: DC
authors.lastname: Smith
mesh_terms: D000726:Androgen Antagonists / Q000627:therapeutic use*; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D009376:Neoplasms, Hormone-Dependent / Q000188:drug therapy / Q000628:therapy*; D009919:Orchiectomy; D011471:Prostatic Neoplasms / Q000188:drug therapy / Q000628:therapy*
chemical_list: D000726:Androgen Antagonists; D018931:Antineoplastic Agents, Hormonal