[Treatment of hormone-resistant prostate cancer]

Abstract

Hormone-resistant prostate cancer is defined by disease progression despite of castration levels of serum testosterone. Due to a good palliative effect and low toxicity, radiotherapy is the cornerstone in treatment of painful bone metastases, the most frequent symptom of advanced hormone-resistant prostate cancer. Patients presenting with spinal cord compression should be assessed for decompressive surgery before radiotherapy. With local growth of prostate cancer and problems with urination, a transurethral resection may palliate symptoms. Postoperative radiotherapy should however be considered for these patients, so local regrowth of the tumour can be prevented. Taxan-based chemotherapy (docetaxel) is the first treatment shown to increase overall survival in patients with hormone-resistant prostate cancer, and is today's standard treatment of Norwegian patients (guidelines from the Norwegian Urological Cancer Group). Secondary hormone treatment and administration of bisphosphonates are other established alternatives for palliation of symptoms in patients with hormone-resistant prostate cancer. The survival of future patients with such cancer is expected to improve if multidisciplinary health care teams with knowledge of prostate cancer tumour biology administer new treatments.