Breast cancer with 52,000 ng businesswoman Tzten new cases per year. Despite the indolent course of the disease and the disease, some patients develop metastases, often associated with the bones and other organs. Once metastasis is diagnosed, the chance of dying from prostate cancer is about BMS-512148 Dapagliflozin to die, than from other causes. For these patients, the treatment is performed with a palliative, often associated with androgen deprivation by pharmacological or surgical orchiectomy. In general, androgen deprivation in 80% to 90% of patients with metastatic prostate cancer. These patients have a median progression-free survival without 12 to 30 months after initiation of treatment.
However, a state of Androgenunabh Dependence After all, historically emerged out in a median overall survival of only 8-16 months from the moment of its appearance. Terms androgen independent-dependent Were hormone-resistant and best Constantly used against castration fa They exchanged not without controversy over the years to describe the progression of the disease despite castration levels of testosterone. However, many recent studies and guidelines in prostate cancer metastases have castrationresistant the term that should be in the following it Rterung used, based on the available therapeutic modality Th for patients whose disease progresses after use, the use of hormone standard.
Definition of a state castration Although most patients initially with metastatic prostate cancer Androgen Highest due to the dependence Dependence of testosterone in the prostate react cancer cells, despite that secondary Re hormonal manipulations are active in some patients, closing the tumor cells of the prostate Acquire Lich the F ability to survive and proliferate in an androgen-depleted medium. The mechanisms that have the transition from androgen sensitivity in androgen-resistant Ph Genotype been partially elucidated rt, And a variety of cellular Ren Signaling pathways in this Ph Involved phenomenon. Accordingly, mutations of the androgen receptor and Ver Changes in the signaling cascade of androgens responsible for the androgen response, which is observed in a minority of patients treated with anti-androgens. In clinical practice, it is important to require in patients with metastatic prostate cancer, the increased treatment compared with those whose disease is caused by a PSA value Ht manifests identify.
Likewise, it is important to determine when a disease not respond initially Highest sensitive to androgen deprivation and better communication between oncologists and urological has been identified as a key element to achieve this goal. There is anecdotal evidence that many patients continue to hormone therapy, despite the failure of previous treatments before. To a medical oncologist For practical reasons, it makes sense that patients with progressive CRPC if the disease progresses w During the anti-androgen, confinement Consider Lich the withdrawal of anti-androgens, and if at least 4 to 8 weeks have passed after the departure of antiandrogens progress can be saturated with measurable best obtained by a single FITTINGS PSA, bone scan