Hormone Refractory Prostate Cancer

There are differing opinions on the definition of hrpc. There are also several terms that are used in these discussions:

Hormone-refractory PC

Hormone-resistant PC

Androgen-Independent PC

We have chosen to use the term hormone-refractory prostate cancer because it seems to be the most commonly used designation for this stage of prostate cancer.

Dr. Stephen Strum coined the term androgen-independent prostate cancer, which he defines as follows:

AIPC is defined as disease progression evidenced by a progressively rising PSA (three consecutive rises of at least 10% each or three rises that invovle an increase of 50% over the nadir PSA) or an increase in tumor mass on bone scan, X-ray, CT scan or MRI despite a castrate level of testosterone (T<20 ng/dl).
He further goes on to say...if a patient's PSA stops falling and begins to rise on ADT(2) or ADT(3), if the T level is castrate, and if the adrenal androgen precursors (DHEA-S and androstendione) are not low, then AIPC is presumed present until proven otherwise.

Note: this paragraph separates out the androgen receptor mutation possibility and the resultant anti-androgen withdrawal effect (declining PSA on stopping an anti-androgen.).

ADT(2) is androgen deprivation therapy with an LHRH agonist and Casodex or Eulexin. ADT(3) is the same plus Proscar. T is testosterone.

INTRODUCTION to Hormone Refractory Prostate Cancer

Because there are differing opinions on what hrpca means, we use a simple working definition. Simply put, we define it as advanced prostate cancer that has resulted in 3 consecutive PSA rises while the individual is still on hormone therapy. The issue of the definition is discussed in detail in Definition of hrpca.
A diagnosis of hrpca is a serious developnt for the family fighting prostate cancer. It often comes accompanied by a grim prognosis that adds an emotional burden. All of the individuals working on this web site have been through this experience. Without exception, they have chosen to reject defeat and to fight this disease with their time, their ingenuity, their resources, and their computers.

What we have learned by sharing our experiences and our research efforts is that there are many choices open to the man with hrpc. These choices can extend survival and maintain quality of life. First, there are lifestyle issues to consider. Next, there is a fairly clear set of therapies that should be considered by everyone. In addition, there are a number of clinical trials that can be considered. These options continue to grow in number as we watch the literature of allopathic medicine and alternative therapies.
This web site does not offer a cure, nor any guarantees of remission. It offers a process of managing this stage of the disease. It offers a forum for learning from other fighters and the opportunity for helping others in their fight. It offers the benefit of working with a committed team to find better solutions inside and outside traditional medicine.

Fighting hrpca means learning as much as you can about your body, the disease, and the therapies. Start your education by reading the section What to do first. If you are hrpca, subscribe to the on-line support list. By these two steps, you can begin the process of coming to terms with hrpca.

Every prostate cancer fighter needs a medical team. We believe in building our teams with doctors who respect the fact that we are in charge of our own treatment program. We respect those doctors for their expert input and compassionate care. We believe that the best way to use the information gained here is to share it with your doctors to arrive at the best decisions. 

Source www.hrpca.org