1 It also remains a common cause of cancer death, with 27,360 deaths anticipated in 2009. Moreover, the

declining US death rates from cardiovascular and smoking-related disease coupled with the aging of the population associated with the Baby Boom generation may beget an anticipated increase in prostate cancer diagnoses in the coming years. It has been estimated that about 10% of the US population was over the age of 65 years in 2000 and that this proportion will approximately double by 2030.2 As a condition of aging men, Inhibitors,research,lifescience,medical prostate cancer is apt to remain a significant, if not growing, public health problem. Current efforts to reduce the mortality burden of prostate cancer have included prostate-specific antigen (PSA)-based screening, but its effect on mortality as assessed in randomized trials, particularly Inhibitors,research,lifescience,medical during the first 10 years of follow-up, is controversial.3,4 But these large-scale

studies agree that the observed decline in prostate cancer mortality that began in Inhibitors,research,lifescience,medical the early 1990s, shortly after PSA testing was introduced in the United States, is most likely explained by more widespread treatment of prostate cancer, selleck compound including hormonal therapy.5 Given these considerations, it is quite likely that hormone deprivation therapy will remain an important treatment for men with prostate cancer. Therefore, a thorough understanding of its long-term side effects is necessary if we are to optimize the care of men with prostate cancer. Androgen Deprivation Therapy for Prostate Cancer Androgen deprivation therapy, the elimination

of testosterone by medical (eg, estrogens or luteinizing hormone-releasing hormone agonists and antagonists) or Inhibitors,research,lifescience,medical surgical castration, has been used to treat prostate cancer since the 1940s.6 This therapy has been most commonly recommended on the basis of randomized, prospective Inhibitors,research,lifescience,medical trial results for men with lymph node metastases identified at the time of radical prostatectomy and as an adjunct to radiation for patients with advanced prostate cancer.7,8 In these settings, use of hormone therapy improves biochemical and clinical response rates, as well as diseasespecific survival. However, hormone therapy has also been commonly used secondly among many patients with localized prostate cancer, for which there are no prospective, randomized trial data demonstrating improved outcomes.9 The same considerations-widespread use without prospective, randomized data to support improved results-apply to hormone therapy for men with biochemical failure after primary surgical or radiation therapy for clinically localized disease.10 The use of androgen deprivation therapy has steadily increased among men with localized prostate cancer irrespective of whether it is low or high risk.