Advances in the management of metastatic androgen-independent prostate cancer.

Over the last century, advances in the management of men with metastatic androgen-independent prostate cancer (AIPC), the type of prostate cancer that has continued to grow after androgen withdrawal or castration, have been slow. Patients with metastatic AIPC usually undergo a cascade of palliative radiation therapy and chemotherapy with modest impact on their inevitable deterioration and death. Currently, there is no therapy capable of achieving a cure for men with AIPC. In the past, chemotherapy was only used for symptomatic patients. Recently there has been a paradigm shift after two landmark studies demonstrated an improvement in survival for men with AIPC treated with docetaxel-based chemotherapy. This review focuses on the management principles and systemic chemotherapy options against AIPC. A good understanding of the prognosis, treatment options and scientific advances is of utmost importance for the physician advising men suffering from AIPC. Research to improve survival and quality of life for our patients should be strongly supported.