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Overview of the treatment of castration-resistant prostate cancer (CRPC)

Author
Nancy A Dawson, MD
Section Editors
Nicholas Vogelzang, MD
W Robert Lee, MD, MS, MEd
Jerome P Richie, MD, FACS
Deputy Editor
Michael E Ross, MD

INTRODUCTION

Although most cases of prostate cancer are diagnosed and treated while disease is localized, some men have evidence of metastatic prostate cancer at presentation, and others develop disseminated disease after their definitive treatment.

Contemporary research has led to the development of multiple active treatment modalities for men with advanced disease, in addition to androgen deprivation therapy (ADT). Management of men with castration-resistant prostate cancer (CRPC) involves the sequential use of these approaches, with the goals of prolonging survival, minimizing complications, and maintaining quality of life.

Treatment options for patients with CRPC and the proper sequencing of the approaches are presented here.

The management of men with castration-sensitive prostate cancer is discussed separately. (See "Overview of the treatment of disseminated castration-sensitive prostate cancer".)

PATIENT POPULATIONS

In many cases, the only manifestation of disseminated disease is an elevated or rising serum prostate-specific antigen (PSA) following definitive local radiation therapy (RT; or surgery). However, some men with prostate cancer have overt metastases either at presentation or as their first sign of recurrence following definitive therapy. In the vast majority of cases, such metastases are predominantly osteoblastic lesions in the axial skeleton; such metastases may vary from asymptomatic to symptomatic.

                                  

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Literature review current through: Jun 2017. | This topic last updated: Jul 19, 2017.
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