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Hormone-refractory prostate cancer: a primer for the primary care physician
Department of Oncology, University of Western Ontario and London Health Sciences Centre, London, Ontario, Canada
Aug 2008 (Vol. 15, Issue 41, Pages( 14 - 20)
PMID: 18700061

Abstract

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  • 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.

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