Hormonal therapy in metastatic prostate cancer: current perspectives and controversies

Abstract

Ever since the introduction of androgen deprivation therapy (ADT) in prostate cancer, various controversial aspects of hormonal therapy have come to light. There has been tremendous progress in this area, marked by several important developments in the availability of various new androgen-suppressing agents and refinements to the existing therapies. Parallel to these developments, various more debatable aspects have arisen in the use of these therapies with regards to their negative impact on quality of life parameters. Various modifications in these hormonal agents, their doses, and protocols have been tried in different scenarios in order to improve ADT tolerability. As a result, these controversies continue to evolve even with optimal use of the androgen ablation therapy. This review assesses the present status of hormonal therapy in metastatic prostate cancer and specifically deals with those aspects of androgen ablation therapy that are still a subject of debate. In spite of the fact that various trials have been conducted, some of which are still ongoing, the multitude of questions related to the best possible use of these hormonal agents have still not been answered. Treatment guidelines concerning these issues are continuing to evolve as progress continues to be made in this field.

Cosmetic Appeal, HRQoL, and Effectiveness of Simple and Pseudotesticular Techniques of Orchidectomy in Prostate Cancer

“…Regional reports from Nigeria indicate that 40%-51.3% of patients with PCa present with metastasis, and up to 94.2% have locally advanced disease at presentation [4,5]. Despite the proven cost and survival benefits of surgical over medical castration [6][7][8], studies in other regions have shown either null difference or preference for medical castration over surgical castration [9][10][11]. Such preferences have been in a bid to avoid surgery or a negative body image due to an empty scrotum [8,9,12].…”