Kylea Potvin1, Eric Winquist. 1. Department of Oncology, University of Western Ontario and London Health Sciences Centre, 790 Commissioners Road East, London, Ontario, Canada.
Abstract
OBJECTIVE: To provide a current and evidence-based clinical review of practical value to primary care physicians encountering men with hormone-refractory prostate cancer (HRPC) in their practice. METHODS: Evidence-based narrative review by two expert clinicians incorporating results of systematic reviews and randomized trials whenever available. RESULTS: HRPC represents the final common pathway to death from prostate adenocarcinoma, the single most prevalent cancer in Canadian men. However, primary care physicians will not encounter these patients with a frequency adequate to develop confidence in their care. HRPC is defined by progressive disease despite castration, and biologically is a characterized by androgen hypersensitivity. It is important to understand that HRPC is a disease spectrum ranging from asymptomatic patients with only a rising prostatic-specific antigen (PSA) level and a prognosis measured in years to extremely symptomatic patients with widespread metastases requiring end-of-life care. Numerous effective management options are now available for HRPC and are selected based on the phase of the disease natural history, and patient comorbidities and preferences. CONCLUSIONS: Men with HRPC have therapeutic options that can improve and maintain both the quality and quantity of their lives. A co-management approach including a medical oncologist and the patient's urologist and primary care physician is preferred.
OBJECTIVE: To provide a current and evidence-based clinical review of practical value to primary care physicians encountering men with hormone-refractory prostate cancer (HRPC) in their practice. METHODS: Evidence-based narrative review by two expert clinicians incorporating results of systematic reviews and randomized trials whenever available. RESULTS: HRPC represents the final common pathway to death from prostate adenocarcinoma, the single most prevalent cancer in Canadian men. However, primary care physicians will not encounter these patients with a frequency adequate to develop confidence in their care. HRPC is defined by progressive disease despite castration, and biologically is a characterized by androgen hypersensitivity. It is important to understand that HRPC is a disease spectrum ranging from asymptomatic patients with only a rising prostatic-specific antigen (PSA) level and a prognosis measured in years to extremely symptomatic patients with widespread metastases requiring end-of-life care. Numerous effective management options are now available for HRPC and are selected based on the phase of the disease natural history, and patient comorbidities and preferences. CONCLUSIONS:Men with HRPC have therapeutic options that can improve and maintain both the quality and quantity of their lives. A co-management approach including a medical oncologist and the patient's urologist and primary care physician is preferred.
Authors: Takahito Suyama; Takumi Shiraishi; Yu Zeng; Wayne Yu; Nehal Parekh; Robert L Vessella; Jun Luo; Robert H Getzenberg; Prakash Kulkarni Journal: Prostate Date: 2010-12-01 Impact factor: 4.104
Authors: Justin P Dassie; Xiu-Ying Liu; Gregory S Thomas; Ryan M Whitaker; Kristina W Thiel; Katie R Stockdale; David K Meyerholz; Anton P McCaffrey; James O McNamara; Paloma H Giangrande Journal: Nat Biotechnol Date: 2009-08-23 Impact factor: 54.908