The Treatment Continuum in the Management of Prostate Cancer Patients: What's New?

ObjectivesSymptom control is a priority in patients with hormone-refractory prostate cancer. However, since the approval of androgen deprivation therapy, there have been few meaningful therapeutic advances. Several current treatment options and novel agents are presented in this review.MethodsExisting and novel therapies were identified and researched through PubMed and published guidelines.ResultsTreatment options include chemotherapy, second-line hormonal manipulations, radiation/radioisotope therapy, and bisphosphonates. Chemotherapy has demonstrated significant palliative benefits, and docetaxel has demonstrated a survival advantage. Hormonal manipulation lowers PSA levels, but has not significantly delayed the course of disease progression. Radiation/radioisotope therapy and bisphosphonates are palliative treatments for patients with bone metastases. Zoledronic acid significantly reduces skeletal morbidity in patients with bone metastases. Several novel treatments, including vaccines and vitamin D analogues, are currently being investigated.ConclusionsAlthough improving survival is the optimal goal, it may not be feasible in elderly patients who may not tolerate some therapies. In addition, advanced HRPC is a multifaceted disease and needs a multidisciplinary approach. Urologists should be familiar with the new challenges that this disease presents and remain involved throughout the continuum of patient care.