Laboratory studies have shown that early hormone therapy does not confer early resistance in metastatic prostate cancer and it may be beneficial. NCCN guidelines recommend individualizing treatment until more data are available on the benefits of early vs delayed androgen therapy.
According to ASCO guidelines, early (immediate) ADT may be offered to men who present with locally advanced disease who choose not to undergo curative-intent treatment. While this approach may confer an overall survival benefit, more research is needed.
The occurrence of two consecutive PSA level elevations is usually considered biochemical recurrence. The PSA velocity, time to PSA nadir, time to PSA-only cancer recurrence, and pattern of PSA-only cancer recurrence are also considered prognostic indicators.
For locally advanced prostate cancer, aggressive local therapy (ie, surgery followed by immediate external beam radiation therapy [EBRT], brachytherapy in combination with EBRT and ADT, and dose-escalated EBRT with ADT), may improve outcomes in locally advanced prostate cancer through improved local control.
Learn more about the management of patients with advanced and metastatic prostate cancer.
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Cite this: Daniel S. Schwartz. Fast Five Quiz: Advanced and Metastatic Prostate Cancer - Medscape - May 02, 2022.