title: Secondary hormonal manipulations in prostate cancer.
abstract: Virtually all patients treated with androgen deprivation eventually develop progressive clinical or biochemical disease despite this therapy. Despite low levels of androgen, the androgen receptor remains active, making secondary hormonal therapies a reasonable clinical approach. Considerations for such patients include antiandrogen withdrawal, sequential use of antiandrogens, adrenal cortex inhibitors, and estrogenic compounds. Collectively, the modest activity of these therapies challenges the notion that advancing prostate cancer will uniformly become "hormone refractory."
authors.affiliation: Urologic Oncology Program, University of California at San Francisco Comprehensive Cancer Center, 1600 Divisadero Street, 3rd Floor, San Francisco, CA 94143, USA. ryanc@medicine.ucsf.edu
authors.forename: Charles J
authors.initials: CJ
authors.lastname: Ryan
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Small
mesh_terms: D000726:Androgen Antagonists / Q000627:therapeutic use; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D002369:Castration; D004967:Estrogens / Q000627:therapeutic use; D006801:Humans; D008297:Male; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000503:physiopathology / Q000601:surgery; D011944:Receptors, Androgen / Q000502:physiology; D015398:Signal Transduction
chemical_list: D000726:Androgen Antagonists; D018931:Antineoplastic Agents, Hormonal; D004967:Estrogens; D011944:Receptors, Androgen