Advanced prostate cancer. Endocrine therapies and palliative measures

Management of patients with metastatic prostate cancer differs from that of patients with other metastatic solid tumors. Because the treating physician is usually the patient's urologist, the primary care physician's main role may be to relieve pain and treat the patient for common side effects of hormone therapies. By being familiar with the forms of systemic treatment-including orchiectomy and the use of estrogens, luteinizing hormone-releasing hormone agonists, and antiandrogens-the primary care physician can also assist patients in making treatment decisions that are individualized to the specifics of disease state, comorbid conditions, age, and value systems.