Fast Five Quiz: Advanced and Metastatic Prostate Cancer

Daniel S. Schwartz, MD, MBA


December 30, 2019

Androgen deprivation therapy is considered the main approach to the treatment of metastatic prostate cancer, but there has been controversy surrounding the timing of its initiation. Laboratory study results have shown that early hormone therapy does not confer early resistance, and it has been associated with significantly longer survival with fewer complications (eg, pathologic fractures, spinal cord compression, ureteral obstruction) in clinical trials versus deferred treatment.

A combination of external radiation therapy, brachytherapy, and hormone therapy is sometimes used for the treatment of locally advanced prostate cancer, but it is unclear whether it offers advantages over hormone therapy and external radiation therapy alone.

Consensus on the definition of a rising PSA level is not consistent in the literature, but many agree that the occurrence of two consecutive PSA level elevations is considered biochemical recurrence. The PSA velocity, time to PSA nadir, time to PSA-only cancer recurrence, and pattern of PSA-only cancer recurrence are also considered prognostic indicators.

For locally advanced prostate cancer, radiation therapy along with androgen ablation therapy is generally recommended, although radical prostatectomy may be an appropriate alternative to radiation therapy in some cases.

Learn more about the management of patients with advanced and metastatic prostate cancer.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.