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Quality of Life for the Hormone Refractory Prostate Cancer Patient (HRPC)

Summary & Participants

Learn about hormone refractory prostate cancer and the current treatments that have can help improve quality of life.

Medically Reviewed On: July 16, 2008

Webcast Transcript

Quality of life for the HRPC patient

ANNOUNCER: When advanced prostate cancer becomes resistant to initial hormone therapy, it is called hormone refractory prostate cancer or HRPC.

ADAM KIBEL, MD: When patients develop metastatic prostate cancer the first thing that is done is they have their hormones removed either by getting shot that removes the hormones or having their testicles removed. What happens over time is that controls the disease for maybe three, four, five years, but usually the cancer comes back.

SAM CHANG, MD: So the prostate cancer no longer is sensitive to the hormone therapy. Instead of being suppressed by hormone therapy, it begins to grow and regain strength.

ANNOUNCER: Physicians will usually recommend that patients with HRPC continue to receive hormone therapy.

SAM CHANG, MD: Once you are in a hormone refractory state, you would think, "Okay, the cancer isn't really susceptible to this hormone therapy. Take me off the hormone therapy." But what's been found actually is that there is still usually a small subset of cancer cells that are sensitive to hormone therapy. Secondly is that when you stop the hormone therapy, some patients or a significant number can have significant pain associated with that withdraw. You can have actually a flare-up of your prostate cancer cells, so most people recommend very strongly that once hormone therapy is established and started and it's the standard therapy, even when the hormone refractory state has been achieved, the hormone therapy should be continued.

ANNOUNCER: There can be side effects associated with ongoing hormonal therapy.

ADAM KIBEL, MD: Patients complain very frequently of hot flashes or hot flushes. People have different names for it and essentially it's like going through menopause for women. The second thing that can happen is they can lose bone mass and muscle which can be very distressing to men, particularly younger men who are diagnosed with the disease. And then the last thing some patients complain that they actually don't feel as sharp. They don't think as clearly.

ANNOUNCER: Most patients with HRPC will receive chemotherapy in addition to continuing hormonal therapy.

MICHAEL COOKSON, MD: Chemotherapy, currently the role is for patients with hormone refractory disease, those who have failed hormonal therapy we now do have survival benefit demonstrated in two independent studies looking at various forms of docetaxel, which is a particular form of chemotherapy.

ANNOUNCER: In recent studies, a combination of docetaxel plus a steroid called prednisone has proven effective in extending the lives of HRPC patients by as long as two years.

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