Chemotherapy in the management of prostate cancer

22 April, 2015 (13:59) | Prostate cancer | By: Health news

Despite this interpretation of the early experience, another generation has passed since the NPCP trials were initiated, without cytotoxic therapy earning a place in the routine management of patients with metastatic prostate cancer. Recent modification of chemotherapy and the introduction of prostate-specific antigen (PSA) testing that permits efficient assessment of ‘response’ have changed this perception.

It is instructive to consider some of the factors contributing to this perception. First, evaluation of clinical response has been difficult. Second, the fact that even patients with disseminated prostate cancer are commonly managed exclusively by urologists has attenuated the experience of medical oncologists in this disease, and very likely has contributed to the slow development of cytotoxic paradigms. Third, there has been an ironic distraction produced by the advent of medical testicular suppression. For some time, clinical research in advanced prostate cancer has seen disproportionate resources expended on randomizing many thousands of patients to variants of hormonal therapies.

Discount HealthCare Medications –

More than a decade of such experience has demonstrated that no matter how complex or expensive we make androgen deprivation, its therapeutic impact is still limited. Finally, the palliative impact of cytotoxic drugs is underappreciated. As pointed out by Slack and Murphy in the quotation above, cytotoxic therapy carefully applied can often provide symptom relief with less morbidity than that associated with narcotics or other palliative

Progress towards more routine assessment of the role of chemotherapy has been made because of a number of factors that have been addressed:

(1) Establishment of standardized response criteria;
(2) Closer ties between medical oncologists and urologists in ‘academic centers of
(3) Recognition of the toxicity and therapeutic limitations of androgen ablation;
(4) Inclusion of quality-of-life end-points in clinical research.