title: [Current treatment of locally advanced and metastatic prostate cancer].
abstract: Despite the broad use of PSA-testing in western medicine, still an estimated 1/3 of carcinomas of the prostate (PC) are diagnosed in a locally advanced or metastatic stage. In the current treatment-algorithm for locally advanced PC, radical prostatectomy, external beam radiation therapy (with and without hormonal therapy) and primary androgen deprivation are available. In fact, in a majority of patients treatment of this tumor stage will be a multimodal approach, which has to be discussed individually. For metastatic PC hormonal deprivation therapy is still the gold standard. Beside LHRH-agonists, surgical castration and complete androgen deprivation today LHRH-antagonists represent the different therapeutic options in this tumor stage. Effects on natural course of this disease have to be balanced to the side effects of long-term therapy. Castration-resistant PC is not the object of this overview even though there are a variety of new medical interventions emerging for the treatment of this stage of PC.
authors.affiliation: Abteilung für Urologie und Andrologie, Krankenhaus der Barmherzigen Brüder, Wien, Austria. antonponholzer@hotmail.com
authors.forename: Anton
authors.initials: A
authors.lastname: Ponholzer
authors.forename: Ferdinand
authors.initials: F
authors.lastname: Steinbacher
authors.forename: Stephan
authors.initials: S
authors.lastname: Madersbacher
authors.forename: Paul
authors.initials: P
authors.lastname: Schramek
mesh_terms: D000465:Algorithms; D000726:Androgen Antagonists / Q000009:adverse effects / Q000627:therapeutic use; D018931:Antineoplastic Agents, Hormonal / Q000009:adverse effects / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000097:blood; D003131:Combined Modality Therapy; D018450:Disease Progression; D007987:Gonadotropin-Releasing Hormone / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D006801:Humans; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D009367:Neoplasm Staging; D009919:Orchiectomy; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D018714:Radiotherapy, Adjuvant; D016032:Randomized Controlled Trials as Topic; D015996:Survival Rate
chemical_list: D000726:Androgen Antagonists; D018931:Antineoplastic Agents, Hormonal; D014408:Biomarkers, Tumor; D007987:Gonadotropin-Releasing Hormone; D017430:Prostate-Specific Antigen