Current treatment of locally advanced and metastatic prostate cancer

• Published in: Wiener medizinische Wochenschrift 2011-08, Vol.161 (15-16), p.377
• Main Authors: Ponholzer, Anton, Steinbacher, Ferdinand, Madersbacher, Stephan, Schramek, Paul
• Format: Article
• Language: ger
• Subjects: Algorithms; Androgen Antagonists - adverse effects; Androgen Antagonists - therapeutic use; Antineoplastic Agents, Hormonal - adverse effects; Antineoplastic Agents, Hormonal - therapeutic use; Biomarkers, Tumor - blood; Combined Modality Therapy; Disease Progression; Gonadotropin-Releasing Hormone - analogs & derivatives; Gonadotropin-Releasing Hormone - therapeutic use; Humans; Lymphatic Metastasis - pathology; Male; Neoplasm Staging; Orchiectomy; Prostate-Specific Antigen - blood; Prostatectomy; Prostatic Neoplasms - mortality; Prostatic Neoplasms - pathology; Prostatic Neoplasms - therapy; Radiotherapy, Adjuvant; Randomized Controlled Trials as Topic; Survival Rate
• ISSN: 1563-258X
• DOI: 10.1007/s10354-011-0014-7

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.