title: Hormone therapy for radiorecurrent prostate cancer.
abstract: BACKGROUND
  The management of patients who relapse after radical radiotherapy is a challenging problem for the multidisciplinary team. This group of men may have been considered ineligible or chosen not to be treated with an initial surgical approach as a result of high-risk features or significant comorbid conditions. It is important not to miss the opportunity for definitive local salvage therapies at this stage, and eligible patients should undergo careful restaging to determine their suitability for these approaches. For those men not suitable for local treatment, androgen deprivation therapy (ADT) remains an option.
  
  
  METHODS
  Literature review of the evidence relating to the management of hormone therapy for radiorecurrent prostate cancer.
  
  
  RESULTS
  Results from retrospective studies have shown that not all men with biochemical relapse will experience distant metastasis or a reduction in survival due to prostate cancer progression. Therefore, the timing of ADT commencement remains controversial. However, it would seem appropriate to offer immediate therapy to men with advanced disease or unfavourable prostate-specific antigen (PSA) kinetics at relapse. Patients with more favourable risk factors and PSA kinetics may be considered for watchful waiting and deferred ADT to avoid or delay the associated toxicities. Patients with non-metastatic disease can be given the option of castration-based therapy or an antiandrogen such as bicalutamide which may have potential advantages in maintenance of sexual function, physical capacity and bone mineral density but at the expense of an increase in gynaecomastia and mastalgia. Recent data suggest the burden of toxicity from ADT may be reduced by the use of intermittent hormone therapy without compromising survival in this group of patients with radiorecurrence.
  
  
  CONCLUSIONS
  Hormone therapy remains an option for men with radiorecurrent prostate cancer.
authors.affiliation: Department of Clinical Oncology, University College Hospital London, First Floor Central 250 Euston Road, London, NW1 2PG, UK, heather_payne@blueyonder.co.uk.
authors.forename: H
authors.initials: H
authors.lastname: Payne
authors.forename: A
authors.initials: A
authors.lastname: Khan
authors.forename: S
authors.initials: S
authors.lastname: Chowdhury
authors.forename: R
authors.initials: R
authors.lastname: Davda
mesh_terms: D000726:Androgen Antagonists / Q000627:therapeutic use*; D000813:Anilides / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000627:therapeutic use; D006177:Gynecomastia / Q000453:epidemiology; D006801:Humans; D008297:Male; D059373:Mastodynia / Q000453:epidemiology; D009364:Neoplasm Recurrence, Local / Q000097:blood / Q000188:drug therapy* / Q000532:radiotherapy*; D009570:Nitriles / Q000627:therapeutic use*; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000188:drug therapy* / Q000532:radiotherapy*; D011878:Radiotherapy; D012008:Recurrence; D012307:Risk Factors; D014105:Tosyl Compounds / Q000627:therapeutic use*; D017211:Treatment Failure; D016896:Treatment Outcome
chemical_list: D000726:Androgen Antagonists; D000813:Anilides; D000970:Antineoplastic Agents; D009570:Nitriles; D014105:Tosyl Compounds; C053541:bicalutamide; D017430:Prostate-Specific Antigen