Castrate Resistant Prostate Cancer

Treatment Options

  • Secondary hormonal therapies
  • Withdrawal responses (e.g., antiandrogens, megestrol acetate)
  • Anti-androgen administration (flutamide, bicalutamide, nilutamide)
  • P450 non-specific inhibitor
    • Adrenal suppressants (ketoconazole)
  • Glucocorticoids (e.g., dexamethasone, prednisone, hydrocortisone)
    • ==> Inhibit secretion of CRH and ACTH ==> decrease Adrenal Androgen
    • have shown modest efficacy
    • Also reduce pain and raise energy level
    • Currently given with Chemo
  • CYP17A inhibitor
    • This enzyme function in testes and in Adrenals
    • It catalyse the conversion of Pregnenolone and Progesterone to weak androgens such as DHEA and Androstendione
    • Abiretarone
  • Estrogens (e.g., DES, fosfestrol, estramustine.)
  • Bisphosphonates (zoledronate)
  • External-beam radiation therapy
  • Bone-seeking radiopharmaceuticals (samarium-153-EDTMP, strontium-89)
  • Chemotherapies (e.g., mitoxantrone, docetaxel.)
  • Experimental therapies