What is the primary treatment strategy for metastatic prostate cancer?

The primary treatment strategy for metastatic prostate cancer focuses on androgen ablation. This approach aims to reduce levels of male hormones, particularly testosterone, which can stimulate the growth of prostate cancer cells. Androgen deprivation therapy (ADT) is effective in controlling the progression of metastatic disease, improving survival rates, and alleviating symptoms by targeting the hormonal influence on prostate cancer growth.

In many cases, androgen ablation can be achieved through surgical castration (orchiectomy) or medical therapies involving luteinizing hormone-releasing hormone (LHRH) agonists or antagonists, and anti-androgens. This is essential because metastatic prostate cancer often relies on androgens for its growth, and depleting these hormones can lead to significant regression of the disease.

Other treatment strategies, such as radiation therapy and surgery, may be considered in localized or advanced cases, but they are not the primary treatment for metastatic disease. Radiation can be used palliatively to relieve symptoms in bone metastases or to treat localized issues, while surgery is typically not feasible for disseminated disease. Chemotherapy may play a role for patients with hormone-resistant disease but is not the first line of treatment in hormone-sensitive metastatic prostate cancer. Thus, androgen ablation remains the cornerstone of management