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Abstract

Volume 14, Issue 3 (May 2012) 14, 451–457; 10.1038/aja.2011.121

Effectiveness and adverse effects of hormonal therapy for prostate cancer: Japanese experience and perspective

Mikio Namiki1, Satoru Ueno1, Yasuhide Kitagawa1, Takashi Fukagai2 and Hideyuki Akaza3

1 Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa 920-8640, Japan
2 Department of Urology, Showa University School of Medicine, Tokyo 142-8666, Japan
3 Research Center for Advanced Science and Technology, University of Tokyo, Tokyo 153-8903, Japan

Correspondence: Professor M Namiki, (namiki1@kenroku.kanazawa-u.ac.jp)

Received 15 July 2011; Revised 27 September 2011; Accepted 30 September 2011; Advance online publication 26 March 2012.

Abstract

Recently, novel anti-androgens and inhibitors of androgen biosynthesis have been developed through the elucidation of mechanisms of castration resistance of prostate cancer. We believe that these new developments will improve hormonal therapy. On the other hand, there has been an increase in criticism of hormonal therapy, because hormonal therapy is supposed to induce adverse effects such as cardiovascular disease. In this review, we have introduced the Japanese experience of hormonal therapy, because we believe that there may be ethnic differences between Caucasians and Asian people in the efficacy and adverse effects of hormonal therapy. First, we showed that primary hormonal therapy can achieve long-term control of localized prostate cancer in some cases and that quality of life of patients receiving hormonal therapy is rather better than previously thought. Neoadjuvant and adjuvant hormonal therapy in cases undergoing radical prostatectomy or radiotherapy are very useful for high-risk or locally advanced prostate cancer. Further clinical trials are required to confirm the efficacy of neoadjuvant or adjuvant hormonal therapy. We showed that the death from cardiovascular diseases in Japanese patients receiving hormonal therapy was not higher than that in the general population. However, efforts should be made to decrease the adverse effects of hormonal therapy, because life-style change may increase the susceptibility to adverse effects by hormonal therapy even in Japan. Managements of endocrine and metabolic dysfunction, such as diabetes mellitus, are essential. New hormonal compounds such as selective androgen receptor modulators capable of specifically targeting prostate cancer are expected to be developed.

Keywords: adverse effects; androgen deprivation therapy; hormonal therapy; prostate cancer

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