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Section Editor: Leonard G. Gomella, MD
One of the major treatments for prostate cancer is androgen-deprivation therapy (ADT), and about 50% of prostate cancer patients are treated with ADT at some point in their disease. ADT is used most frequently for patients with local but advanced prostate cancer or metastatic prostate cancer. The rate of ADT use in the USA increased in the 1990s and continues to be high today. ADT treatments work to decrease the amount of androgens in the prostate microenvironment to prevent this tumor progression from initiating via testosterone. This can be done with medical or surgical castration (orchiectomy). Many different types of drugs are available and approved for use as ADT for prostate cancer patients, but use different mechanisms of action (eg, LHRH agonists, LHRH antagonists, CYP17 inhibitors, and older and newer anti-androgens). There are many issues around hormone therapy that not all doctors agree on, such as the best time to start and stop it and the best way to give it. Studies are now looking at these issues, and we hope that this Next Generation Learning Center will provide additional information for the practicing physician.
Leonard G. Gomella, MD, FACS, discusses the evolving role of genetic testing for inherited family risks in prostate cancer patients. He advises urologists to be attentive to recent developments in genetic testing in order to better detect cancers in individual patients and their family members.
Leonard G. Gomella, MD
Thomas Jefferson University
Leonard Gomella, MD, is the Bernard W. Godwin, Jr. Professor of Prostate Cancer and Chairman of the Department of Urology at the Sidney Kimmel Medical College. He joined the Jefferson faculty in 1988 and was appointed Chair in 2002. He serves as Senior Director for Clinical Affairs for the NCI designated Sidney Kimmel Cancer Center at Jefferson, Clinical Director of the SKCC Network and Urology Chair for NRG (RTOG). Dr. Gomella is involved in translational basic science and clinical research in the development of new diagnostic techniques and treatments for prostate and bladder cancer through the Sidney Kimmel Cancer Center as Co-Leader of the Biology of Prostate Cancer Program.