Timing and choice of androgen ablation
Open Access
- 27 July 2004
- journal article
- review article
- Published by Springer Science and Business Media LLC in Prostate Cancer and Prostatic Diseases
- Vol. 7 (3), 217-222
- https://doi.org/10.1038/sj.pcan.4500733
Abstract
Hormone therapy remains central to the management of advanced prostate cancer. Evidence has accrued to suggest benefits from earlier treatment. Trials which demonstrate significant improvements in disease-specific survival may be underpowered to show overall survival benefits, due to the effect of mortality from unrelated causes. Toxicity, particularly the risk of osteoporosis, causes increasing concern, particularly where many years of use may be contemplated as in early relapse after curative treatment. Strategies to reduce toxicity include use different drugs, notably antiandrogens and with renewed interest in oestrogens in low dose or administered parenterally, and deferred and intermittent treatment. Further improvements in drug development, reducing toxicity, and identification of the cause of hormone refractory disease and its prevention would revolutionise the use of hormone therapy. Currently, deferred treatment, used selectively and with careful follow-up, remains an option for selected patients.Keywords
This publication has 20 references indexed in Scilit:
- Transdermal Estradiol Therapy for Advanced Prostate Cancer—Forward to the Past?Journal of Urology, 2003
- A Randomized Trial Comparing Radical Prostatectomy with Watchful Waiting in Early Prostate CancerThe New England Journal of Medicine, 2002
- BICALUTAMIDE MONOTHERAPY COMPARED WITH CASTRATION IN PATIENTS WITH NONMETASTATIC LOCALLY ADVANCED PROSTATE CANCER: 6.3 YEARS OF FOLLOWUPJournal of Urology, 2000
- Improved Survival in Patients with Locally Advanced Prostate Cancer Treated with Radiotherapy and GoserelinThe New England Journal of Medicine, 1997
- Osteoporosis After Orchiectomy for Prostate CancerJournal of Urology, 1997
- Experience with low‐dose oestrogen in the treatment of advanced prostate cancer: a personal viewBJU International, 1996
- Intermittent androgen suppression in the treatment of prostate cancer: A preliminary reportUrology, 1995
- Comparison of LHRH Analogue (Zoladex) with Orchiectomy in Patients with Metastatic Prostatic CarcinomaBJU International, 1991
- Zoladex versus orchiectomy in treatmentof advanced prostate cancer: a randomized trialUrology, 1991
- Leuprolide versus Diethylstilbestrol for Metastatic Prostate CancerThe New England Journal of Medicine, 1984