Secondary hormonal therapies in the treatment of XXXX .

@entity1 @entity12195 @entity137 @entity263 @entity5 @entity3102 @entity1887 @entity6239 @entity134 @entity342 @entity715 @entity4742 @entity99 @entity288
@entity1 with @entity342 -independent @entity263 demonstrate progression of disease, despite chemical or surgical castration, and have a poor prognosis. @entity5 progression may be manifest as an asymptomatic increase in serum prostate-specific antigen (PSA) or may be accompanied by symptomatic and/or radiographic evidence of @entity5 growth. Observation remains a reasonable choice for asymptomatic @entity1 . However, many @entity1 remain anxious about withholding further treatment and, although studies have not demonstrated a survival benefit with second-line hormonal therapy, it may be appropriate to consider these therapies. In @entity1 who have radiographic and/or symptomatic progression, the use of second-line hormonal therapy is more easily justified. Treatment options include: (1) secondary use of antiandrogens (eg, high-dose @entity12195 ), (2) therapies targeted against adrenal @entity134 synthesis (eg, @entity3102 , @entity6239 , and @entity288 ), and (3) estrogenic therapies (eg, @entity4742 ). Symptomatic improvement and PSA-level decreases of > or =50% have been reported in approximately 20% to 80% of @entity1 with @entity342 -independent @entity263 who receive such second-line hormone therapies, with a typical response duration of 2 to 6 months. @entity137 is generally mild for these oral therapies, although serious side effects, including @entity1887 , @entity99 , and @entity715 , may occur. In conclusion, secondary hormonal therapies have a significant role in the treatment of @entity1 with @entity342 -independent @entity263 . Further research is needed to understand their optimal use.
