Counterpoint: Men should be treated for hormone refractory prostate cancer with systemic chemotherapy when they are symptomatic, and not before.
The benefits of chemotherapy in men with symptomatic HRPC include pain relief, better physical functioning and improved quality of life. These have been well established in randomized trials. A meaningful or statistically significant improvement in survival has yet to be demonstrated. In the absence of a survival benefit, there is concern that treating men when they are free of symptoms may have a negative impact upon quality of life due to drug related toxicity. It will also limit or eliminate any therapeutic options when symptoms eventually develop and therapy is needed most.
Moore
Malcolm J
MJ
Princess Margaret Hospital, University of Toronto, Toronto, Ontario, Canada.
D006728:Hormones / Q000627:therapeutic use; D006801:Humans; D008297:Male; D011471:Prostatic Neoplasms / Q000150:complications / Q000188:drug therapy*; D013997:Time Factors; D017211:Treatment Failure
D006728:Hormones