Hormone therapy for radiorecurrent prostate cancer.

Area of Science:

• Oncology
• Urology

Background:

• Management of prostate cancer relapse post-radiotherapy presents challenges for multidisciplinary teams.
• Patients may have contraindications or comorbidities precluding initial surgery.
• Salvage local therapies and androgen deprivation therapy (ADT) are key considerations.

Purpose of the Study:

• To review evidence on hormone therapy for radiorecurrent prostate cancer.
• To inform clinical decision-making regarding ADT timing and modality.

Main Methods:

• Literature review of studies on hormone therapy for radiorecurrent prostate cancer.

Main Results:

• Biochemical relapse does not always lead to distant metastasis or reduced survival.
• ADT commencement timing is debated; immediate therapy for advanced disease/unfavorable PSA kinetics is suggested.
• Deferred ADT or watchful waiting may suit patients with favorable factors, reducing toxicity.
• Non-metastatic options include castration or antiandrogens (e.g., bicalutamide) with specific side effect profiles.
• Intermittent hormone therapy may reduce ADT toxicity without compromising survival.

Conclusions:

• Hormone therapy remains a treatment option for men with radiorecurrent prostate cancer.
• Individualized treatment approaches are necessary to balance efficacy and toxicity.