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Prostate Cancer: An Update on Disease Pathogenesis and Drug Therapy

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Overview

   Over the last decade, much progress has been made in both the diagnosis and treatment of prostate cancer. One contributing factor is prostate-specific antigen (PSA) screening, which began in the 1980s. Widespread screening is controversial; however, because many early-stage cancers are slow-growing and treatment may result in more harm than benefit. Conversely, the curative treatments for early disease (i.e., surgery and radiation) offer improved success rates. Treatment options for advanced disease are also better - hormonal therapy is commonly started earlier in the course of the disease, and chemotherapeutic regimens have improved. Despite positive trends, prostate cancer remains the most common non-skin cancer in men, and the second most lethal tumor among men. About 1 in 6 men will be diagnosed with prostate cancer, but only 1 in 35 men will die of it.

   This issue provides an overview of prostate cancer including risk factors, screening recommendations, symptoms, and diagnosis. Recommended treatment options to consider for early as well as more advanced cancer are discussed. A drug review focuses on the hormonal therapies (luteinizing hormone-releasing hormone [LHRH] agonists and antiandrogens) that are typically used for both localized prostate cancer and more advanced cancer. Strategies to manage common and serious adverse effects of these treatments are provided. Finally the Patient Connection offers answers to questions that patients often have about prostate cancer and hormonal therapies.

Publication Date: Jan-1-09
Expiration Date: Jan-1-12
CE Credit: 1.5 (0.15 CEU)
Type of activity: Knowledge-based

This program was developed by The Rx Consultant and published by Continuing Education Network, Inc. The Rx Consultant accepts no advertising or financial support from the pharmaceutical industry and is funded solely by the purchase of programs. The Rx Consultant is dedicated to providing unbiased, balanced information to health care practitioners.

Programs developed by The Rx Consultant are written by health care providers with expertise in the topic area, peer-reviewed, extensively edited, and fact-checked. This development process was created to insure that every program presents information that is current, accurate, relevant to "real world" health care providers, and written in an easy reading, "plain English" style.

Authors

Ellen Whipple Guthrie, Pharm.D., Clinical Assistant Professor, University of Georgia College of Pharmacy; Pharmacist, Children's Healthcare of Atlanta.

Disclosure Statement

Dr. Guthrie reports no financial or personal relationship with any commercial interest producing, marketing, reselling, or distributing a product or service that appears in this issue.

Guest Editorial Advisor

Jennifer Chang, PharmD, BCPS

Target Audience

This accredited program is targeted to pharmacists and nurses.

Goals & Objectives

At the conclusion of this program, participants will be able to:

    1. Describe the epidemiology and clinical presentation of prostate cancer.
    2. Discuss the recommendations from the American Cancer Society regarding annual PSA screening and digital rectal exam.
    3. Describe the recommended treatment options for early stage (localized) and advanced prostate cancer.
    4. Educate a patient about the potential benefits and common adverse effects of androgen deprivation therapy.

Exam & Credit Statement procedures

Upon successful completion of this program and the post test (70%), 1.5 hours of continuing education credit will be awarded. To receive credit and your exam score, please complete the exam questions and program evaluation.

Editorial and Review Board

Editor and CE Administrator

Terry M. Baker, PharmD

Associate Editor and CE Coordinator

Tracy Farnen, PharmD

Associate Editors

James Chan, PharmD, PhD
Pharmacy Quality and Outcomes Coordinator
Kaiser Permanente
Oakland, CA

Associate Clinical Professor
School of Pharmacy
University of California San Francisco
San Francisco, CA

Ron Finley, RPh
Lecturer
Department of Clinical Pharmacy
University of California San Francisco
San Francisco, CA

Associate Member of the UCSF Memory and Aging Center
Alzheimer's Research Center

Consultant Pharmacist to the Institute on Aging-On Lok Senior Health
Institute on Aging Alzheimer's Day Care Center

Angie S. Graham, PharmD
Drug Information Coordinator
Stanford Hospital and Clinics
Stanford University Medical Center
Stanford, CA

Julio R. Lopez, PharmD, FCSHP
Chief of Pharmacy Service
VA Northern California Health Care System

Adjunct Clinical Professor
College of Pharmacy
Touro University
Vallejo, CA

Assistant Clinical Professor
School of Pharmacy
University of California, San Francisco
San Francisco, CA

Adjunct Professor
Thomas J. Long School of Pharmacy
University of the Pacific
Stockton, CA

Visiting Associate Professor and Lecturer
Nursing School
Samuel Merritt University
Oakland, CA

Pamela Mausner, MD

Joshua J. Neumiller, PharmD, CDE, CGP, FASCP
Assistant Professor
Department of Pharmacotherapy
College of Pharmacy
Washington State University
And
Elder Services of Spokane
Spokane, WA

Candy Tsourounis, PharmD
Professor of Clinical Pharmacy
Medication Outcomes Center
Department of Clinical Pharmacy
School of Pharmacy
University of California, San Francisco
San Francisco, CA

Senior Editorial Advisor

Gerard Hatheway, PharmD, PhD

Editorial Advisors

Jocelyn Chan, PharmD
Belinda M. Danielson, RPh
Christopher M. DeSoto, PharmD
Cynthia Chan Huang, PharmD, MBA
Fred Plageman, PharmD


Editorial Advisor and Clinical Practice Consultant for Nurse Practitioners

Emily K. Meuleman, RN, C, MS

CE for this article is no longer valid.

Accreditation Statements

The Rx Consultant is a publication of Continuing Education Network, Inc.

Continuing Education Network, Inc. is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.
Continuing Education Network is approved by the California Board of Registered Nursing, Provider Number CEP 13118. Programs approved by CA BRN are accepted by most State Boards of Nursing.

About the Rx Consultant

The Rx Consultant is a monthly publication dedicated to providing health care professionals with the information they need to educate patients about drugs and manage drug therapy. The reader is responsible for confirming the information presented here and interpreting it in relation to each patient's specific situation before utilizing the information.

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CE for this article is no longer valid.