Therapeutics clinic

An update on the medical management of prostate cancer

Minh Tran, Phillip D Stricker AO



Over the past decade many advances have been made in the medical management of prostate cancer. Various treatment options are now available to patients, nearly all of which have distinct mechanisms of action that can improve survival in those with progressive metastatic prostate cancer.


An addendum for this article was published in the March 2015 issue of Medicine Today. The Table and section ‘New treatment options for CRPC’ in the full text PDF of this article (see link above) have been corrected.

Article Extract

Great advances have been made in the medical management of prostate cancer. Androgen deprivation therapy (ADT) remains the mainstay first-line treatment option in patients with nonmetastatic prostate cancer (together with adjuvant radiotherapy), in those with recurrent disease following definitive treatment and in those with metastatic prostate cancer. Patients who stop responding to ADT develop castrate resistant prostate cancer (CRPC), with docetaxel chemotherapy remaining the standard of care in this setting. In the past five years, a variety of treatment options with distinct mechanisms of action have emerged for progressive metastatic CRPC and have been shown to improve overall survival. The optimal sequence for delivering these agents currently remains unclear. This therapeutic update reviews the main features of the medications available for the management of prostate cancer.

Picture credit: ©Zephyr/SPL/ Coloured urogram showing prostate cancer in a 60-year-old man.