Chemotherapy for prostate cancer: implementing early systemic therapy to improve outcomes

Gary R. MacVicar2 and Maha Hussain1

(1) University of Michigan Comprehensive Cancer Center, 7314 CCGC, 1500 E. Medical Center Drive, Ann Arbor, MI 48109-0946, USA
(2) Division of Hematology/Oncology, Northwestern University, Chicago, IL 60611, USA

Published online: 5 November 2005

Abstract Prostate cancer remains a significant health concern for men in the USA as it is a leading cancer diagnosis and a cause of death. With the use of prostate-specific antigen or screening, a stage migration has occurred with an increase in the number of men diagnosed with early-stage disease. The optimal primary management of these men is evolving, but despite adequate local treatment a significant percentage will develop either biochemical or clinical evidence of recurrent disease. Several criteria for risk stratification have been developed, thus, improving the ability to identify a high-risk population. Small studies have been reported demonstrating the feasibility of neoadjuvant or adjuvant chemotherapy in conjunction with either radiation or radical prostatectomy in this high-risk population, and large phase III studies are ongoing. With the advent of life-prolonging chemotherapy in the hormone-refractory setting, attention must now also be given to early-stage disease so as to develop multi-modality approaches with the hope of increasing survival and ultimately providing a cure.
Keywords Prostate cancer - Adjuvant therapy - Neoadjuvant therapy - Multimodality therapy - Chemotherapy