Abstract

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• Hormone-refractory prostate cancer (HRPC) is a disabling and incurable condition, which commonly causes pain, fatigue, and decreased physical activity. No therapies improve survival. Therefore any therapy advocated must be interpreted in the light of its ability to improve disease-related symptoms and quality of life. The role of systemic chemotherapy has been questioned because of the potential for toxicity that may actually make patients feel worse. Recent studies of mitoxantrone plus prednisone in HRPC have used pain relief as the primary endpoint. These studies demonstrate that the combination therapy is superior to prednisone alone in providing significant relief of pain and that these are associated improvements in a variety of quality of life domains.