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Abstract
Prostate cancer is the most common cancer in men (excluding non-melanoma skin cancer), it increases with age in men older than fifty years and it is the second most common cause of death from cancer in men (Hummel, 2003).
The majority (86%) of newly diagnosed men have organ-confined prostate cancer and achieve excellent 5-year survival rates with radical prostatectomy or definitive radiation therapy.
However, those with metastatic disease on presentation or relapsing disease after definitive local therapy require multiple therapies.
Androgen ablation therapy will often produce dramatic tumor involution, but it is not curative.
Whether through adaptation or clonal selection, the tumor will, in time, become resistant to hormonal therapy and resume growth (Michael et al., 2005).
The development of hormone refractory prostate cancer is virtually a universal issue that affect all patients treated with androgen deprivation therapy.
Somatic alterations of the androgen receptor are frequently observed in patients with evidence of disease progression after androgen deprivation therapy (Nelson et al., 2003).
When patients have a heavy tumor burden, particularly with bone metastases, the time from progression of disease to death, is only 12-19 months. So it is important to provide support for those patients and to get the best possible outcome for them in the final stages of their life (Noel, 2006).
In recent years, prostate specific antigen (PSA) testing has become an indispensable tool in prostate cancer. In addition to allowing risk stratification and prognosis determination, (PSA) testing also allows the earlier detection of hormone-refractory prostate cancer (HRPC) (John Aderson, 2006).