Androgen blockade in prostate cancer in 2002: major benefits on survival in localized disease.
The last 20 years have witnessed major advances in the field of prostate cancer, both in terms of diagnosis and treatment. Using screening with PSA, 99% of prostate cancers can now be diagnosed at a clinically localized or potentially curable stage. Over a 11-year period starting in 1988, the Québec screening study performed among 45,000 men aged 45-80 years has shown that the prostate cancer death incidence has decreased by 64% in men who had screening. The impact of screening, however, requires early application of the most efficacious treatments. In this context, the most important recent therapeutic advance in the field of prostate cancer is androgen blockade, namely medical castration with LHRH agonists, the availability of pure antiandrogens and combined androgen blockade (CAB) using medical or surgical castration in association with a pure antiandrogen. In the six studies performed in localized or locally advanced disease, the improved cancer-specific survival ranges between 37 and 81% at 5 years of follow-up for patients who received androgen blockade. On the other hand, data already available show that long term and continuous (not intermittent) androgen blockade is highly efficient and can achieve long term control or possible cure of localized prostate cancer.
Labrie
Fernand
F
Molecular Endocrinology and Oncology Research Center, Laval University Medical Center (CHUL), Laval University, 2705 Laurier Boulevard, Quebec City, Quebec, Canada G1V 4G2. fernand.labrie@crchul.ulaval.ca
D000368:Aged; D000369:Aged, 80 and over; D000726:Androgen Antagonists / Q000627:therapeutic use*; D000728:Androgens / Q000378:metabolism; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D011792:Quebec; D016032:Randomized Controlled Trials as Topic; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome
D000726:Androgen Antagonists; D000728:Androgens; D018931:Antineoplastic Agents, Hormonal