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According to Cancer Research UK, prostate cancer is the most common cancer affecting men in the UK with age being the most significant risk factor. Prostate cancer is classified as an adenocarcinoma, or glandular cancer, that begins when normal semen-secreting prostate gland cells mutate into cancer cells. The prostate gland requires male hormones known as androgens to work properly. Androgens include testosterone which is made in the testes. The testes produce 90–95% of circulating testosterone, with the remainder being supplied by the adrenal gland. In treating systemic prostate cancer, testosterone produced by the testes is targeted. Hormone therapy, referred to as androgen deprivation therapy (ADT), involves either surgical castration (orchiectomy) or medical castration. Medical castration may involve the use of gonadotropin releasing hormone (GnRH) agonists/antagonists, oestrogens or antiandrogens in combination with GnRH. A provider may further decide to use a complete androgen block or intermittent androgen deprivation as ADT therapy. However, ADT therapy only appears to delay the progression of the disease and has not been proved to improve overall survival. Cabazitaxel has been approved as a second-line agent for men with metastatic castrate-resistant prostate cancer (CRPC) in whom …
Competing interests None.
Provenance and peer review Not commissioned; externally peer reviewed.