Immediate bilateral orchiectomy is indicated when spinal cord compression is present because it avoids the possibility of a flare response that can occur during the first 3 weeks of treatment with a luteinizing hormone-releasing hormone (LHRH) agonist.
The appropriate treatment algorithm following biochemical recurrence has been controversial. Factors to consider include the type of local therapy (if any) previously used, the patient's life expectancy, the likelihood of cure, the risk for increased morbidity, and the patient's quality of life. Therapeutic options include LHRH agonists, LHRH antagonists, gonadotropin-releasing hormone antagonists, complete androgen blockade, nonsteroidal antiandrogen monotherapy, bilateral orchiectomy, or enrollment in a clinical trial.
Early salvage radiation therapy may reduce the overtreatment associated with adjuvant radiation therapy without compromising disease control in patients with advanced or metastatic prostate cancer.
Learn more about the management of advanced and metastatic prostate cancer.
Access the NCCN Clinical Practice Guidelines for Prostate Cancer, NICE Guidance – Prostate Cancer: Diagnosis and Management and Cancer of the Prostate: ESMO Clinical Practice Guidelines for recommendations for prostate cancer screening, diagnosis, and therapeutic strategies.
Medscape © 2022 WebMD, LLC
Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.
Cite this: Daniel S. Schwartz. Fast Five Quiz: Advanced and Metastatic Prostate Cancer - Medscape - May 02, 2022.