Chemotherapy of hormone refractory prostate cancer

An increasing life expectancy and the growing number of largely healthy older men have lead to more patients with hormone insensitive relapses after palliative hormone or curative therapy for prostate cancer. After 10 years without therapeutic improvement for hormone refractory prostate cancer, the introduction of new substances has led to a revival of chemotherapy. Although a definitive cure is still not possible, such chemotherapy fulfils important palliative criteria-good toleration and an improvement in quality of life -in addition to distinct long-term remission. For example,taxane as a monotherapy or in combination with estramustine is effective and well tolerated while mitoxantrone in combination with prednisolone, although of limited effectiveness, leads to a substantial reduction in symptoms. Although evidence for increased longevity through modern chemotherapy is available,this has still not been definitively demonstrated. The substantial reduction in pain and therapy related morbidity frequently makes chemotherapy for hormone refractive prostate cancer a superior alternative to simple pain and complication management.