Supportive care in the patient with hormone refractory prostate cancer

Despite the advances being made in prostate cancer screening and early detection, a large percentage of patients will eventually be classified as "hormone refractory." Patients entering this phase are no longer curable, and therapies instituted in this setting are primarily palliative in nature. As a result, the onus on those working in the field of urologic oncology becomes managing the plethora of symptoms these patients experience as a result of both their disease and the treatment modalities used at this stage. The intent of this article is to provide an overview of some of these symptoms with guidelines for their management. Principles of pain management and additional manifestations requiring supportive care such as anorexia, constipation, anemia, urinary obstruction, and psychological concerns are discussed.