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Prostate cancer in the late 1990s: hormone refractory disease options
1Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
Abstract:
Prostate cancer is the most common tumor and second most common cause of cancer death in American men. Advanced prostate cancer patients commonly have painful skeletal bony metastases. Although hormonal therapy is very effective initially, hormone-refractory prostate cancer may be associated with bone pain and other symptoms such as urinary obstruction. Aside from oral and parenteral non-narcotic and narcotic medications, several recent FDA-approved outpatient medications are effective for palliation of painful bony metastases. Mitoxantrone chemotherapy in combination with glucocorticoids and the radioisotopes strontium-89 and samarium-153-lexidronam are now available. Urologic nursing personnel should be familiar with these new and complementary modalities.
Insights
Advanced prostate cancer can cause painful bone metastases. New FDA-approved outpatient treatments, including chemotherapy and radioisotopes, offer effective palliation for bone pain and other symptoms in hormone-refractory prostate cancer patients.
Area of Science:
- Oncology
- Urology
- Palliative Care
Background:
- Prostate cancer is a leading cause of cancer death in American men.
- Advanced prostate cancer frequently involves painful skeletal metastases.
- Hormone-refractory prostate cancer presents challenges with bone pain and urinary obstruction.
Purpose of the Study:
- To review current and emerging palliative treatments for painful bone metastases in advanced prostate cancer.
- To inform urologic nursing personnel about new therapeutic options.
Main Methods:
- Review of recent FDA-approved outpatient medications for palliation of bony metastases.
- Discussion of chemotherapy (mitoxantrone with glucocorticoids) and radioisotope therapies (strontium-89, samarium-153-lexidronam).
Main Results:
- Several new outpatient medications are effective for palliating painful bone metastases.
- Mitoxantrone chemotherapy and specific radioisotopes provide complementary palliative options.
Conclusions:
- Urologic nursing personnel require familiarity with novel palliative modalities for advanced prostate cancer.
- These new treatments offer improved management for symptoms like bone pain and urinary obstruction.