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18 Cards in this Set

  • Front
  • Back
what is the primary therapeutic approach in metatstatic prostate cancer?
androgen deprivation therapy (ADT)
does ADT prolong survival?
yes it may, but is not curative
how is ADT accomplished?
removing the testes or by giving:
GnRH agonists
Estrogens
androgen receptor blockers
how do GnRH agonists work?
reduce LH production --> decrease testicular androgens
what is abarelix?
GnRH agonist
how does estrogen therapy used in prostate cancer?
reduces LH production
what are the nonsteroidal androgen receptor blockers?
flutamide
nilutamide
bicalutamide
what are the steroidal receptor blockers?
cyproterone
megestrol
what is complete androgen blockade (CAB)?
use of androgen receptor blockers and GnRH agonists
what are the adverse effects of androgen receptor blockers?
less: sexual dysfunction, hot flashes more sparing of bone and muscle than GnRH
more gynecomastia than GnRH
what are alternatives to ADT?
intermittent androgen deprivation (IAD)
antiandrogen monotherapy
what are the adverse effects of ADT?
osteoporosis
vasomotor symptoms (hot flashes)
gynecomastia
how is osteoporosis due to ADT manages?
Ca, vit D
increase exercise
bisphosphonates: pamidronate and zoledronate
how are the vasomotor symptoms of ADT managed?
megesterol
transdermal estrogen
SSRIs
acupuncture
how is gynecomastia due to ADT managed?
radiation therapy
tamoxifen
aromatase inhibitors
surgery
what are the treatment options of androgen independent prostate cancer?
antiandrogen withdrawal
second-line hormone therapy
systemic chemotherapy
adjunctive therapies
what is antiandrogen withdrawal syndrome?
when prostate cancer becomes unresponsive to antiandrogens, withdrawing them reduces the cancer
what chemotherapy is recommended for prostate cancer?
docetacel plus prednisone