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First-line hormonal therapy for metastatic prostate cancer 

First-line hormonal therapy for metastatic prostate cancer
Chapter:
First-line hormonal therapy for metastatic prostate cancer
Author(s):

Ajjai S Alva

and Maha Hussain

DOI:
10.1093/med/9780199561421.003.0005
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date: 18 January 2018

Androgen deprivation therapy ((ADT) gonadal suppression) is the standard first line therapy for patients with metastatic prostate cancer. This can be accomplished medically with the use of an LHRH-agonist or antagonist or by bilateral orchiectomy

The addition of an anti-androgen (short course or continuous) must be individualized taking into account symptoms, sides effects, and costs of therapy

Pending results of completed randomized trials, intermittent androgen deprivation therapy can be used but is considered experimental

Physicians managing patients should attend to the long-term toxicity from ADT, particularly effect on BMD and the metabolic syndromes

Considering the inevitability of progression in virtually all patients undergoing ADT, new treatment strategies targeting mechanisms of progression are an active area of investigation.

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