Second-line treatment of metastatic prostatic carcinoma.

Second-line palliative treatment of patients who have failed hormone therapy for advanced prostate cancer remains an important challenge in this disease. Very few agents have been shown to have a positive impact on survival, and toxicity is often therapy limiting in this elderly group of patients. Improvements in pain and performance status with maintenance of a reasonable functional status are worthwhile goals of any therapy at this stage. The earlier diagnosis of progressive disease from a rising prostate-specific antigen (PSA), and the use of validated quality of life questionnaires, can lead to useful improvements in the quality of the lives of these patients whose quantity we cannot at present lengthen.