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 (.15 CEU)
Type of activity: Knowledge-based

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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

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

Accreditation Statements

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

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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Target Audience

This accredited program is targeted to pharmacists and nurses.

Exam and 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.

Educational Goals and 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.