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Review: Risk stratification in the hormonal treatment of patients with prostate cancer

Division of Urologic Surgery and Duke Prostate Center, Duke University Medical Center, PO Box 3707, Durham, NC 27710, judd.moul{at}duke.edu

Judd W. Moul

Division of Urologic Surgery and Duke Prostate Center, Department of Surgery, Duke University Medical Center, Durham, NC 27710

Ping Tang

Division of Urologic Surgery and Duke Prostate Center, Department of Surgery, Duke University Medical Center, Durham, NC 27710

Danielle A. Stackhouse

Division of Urologic Surgery and Duke Prostate Center, Department of Surgery, Duke University Medical Center, Durham, NC 27710

Leon Sun

Division of Urologic Surgery and Duke Prostate Center, Department of Surgery, Duke University Medical Center, Durham, NC 27710

Prostate cancer (PCa) is the most common type of cancer found in American men, other than skin cancer. The American Cancer Society estimates that there will be 186,320 new cases of prostate cancer in the United States in 2008. About 28,660 men will die of this disease this year and PCa remains the second-leading cause of cancer death in men. One in six men will get PCa during his lifetime and one in 35 will die of the disease. Today, more than 2 million men in the United States who have had PCa are still alive. The death rate for PCa continues to decline, chiefly due to early detection and treatment, and improved salvage therapy such as hormone therapy (HT). HT continues to be a mainstay for primary-recurrent PCa and locally-advanced PCa. However, HT is associated with many undesirable side effects including sexual dysfunction, osteoporosis and hot flashes, all of which can lead to decreased quality of life (QOL). These risks are seen in both long- and short-term HT regimens. Additionally, research in recent years has revealed trends related to clinico pathological variables and their predictive ability in HT outcomes. Awareness of the potential adverse effects, the risks associated with HT and the prognostic ability of clinical and pathological variables is important in determining optimal therapy for individual patients. A rigorous evaluation of the current scientific literature associated with HT was conducted with the goal of identifying the most favorable balance of benefits and risks associated with HT.

Key Words: prostate cancer • recurrence • survival • hormonal therapy • toxicity • risk factors • quality of life

This version was published on September 1, 2009

Therapeutic Advances in Medical Oncology, Vol. 1, No. 2, 79-94 (2009)
DOI: 10.1177/1758834009340164


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