Tariq Parvez, Tariq Parvez.
Management of advanced cancer Prostate.
Professional Med J Jan ;8(2):168-78.

Prostate cancer is a significant health problem with the aging of our population and is the focus of increasing attention in our society. Metastatic disease is incurable, and the goals of treatment should be to prolong survival and improve the patient`s quality of life. Systemic treatment of metastatic prostate cancer includes hormonal therapy, chemotherapy, radiopharmaceuticals, investigational therapy, and supportive therapy. Hormonal therapy is the mainstay of systemic therapy. Hormonal therapies are being used increasingly earlier in the course of prostate cancer for poor-risk patients. The primary treatment for symptomatic metastatic prostate cancer is bilateral orchiectomy, diethylstilbestrol (DES), or a luteinizing hormone-releasing hormone (LHRH) agonist. Antiandrogens have been used as mono therapy without suppression of testicular androgens. Testicular androgen deprivation combined with an antiandrogen would be more effective than testicular androgen deprivation alone. This is referred to as combined androgen or maximal androgen blockade. A number of trials demonstrated a significant benefit with combined androgen blockade. The sequence of second-line hormone treatment, chemotherapy, radiation therapy, and supportive care is a judgment decision. These secondary hormonal treatments can be used alone or in combination with other systemic therapies. Chemotherapy has emerged as an exciting new treatment that may affect both local and systemic control of prostate cancer. This is a review article.

PakMediNet -Pakistan's largest Database of Pakistani Medical Journals - http://www.pakmedinet.com