ABSTRACT
Prostate cancer cells metastasize primarily via the lymphatic system.
The most common sites are pelvic lymph nodes, bone, lung, and liver.
In the prostate-specific antigen (PSA) era, metastatic prostate cancer most commonly occurs following progression after primary treatment for localized disease.
Biochemical recurrence is defined as the presence of a rising PSA level following primary therapy with surgery or radiation. Biochemical recurrence may occur years before the onset of clinical metastatic disease.
The mainstay of treatment for men with metastatic prostate cancer is androgen deprivation.
The quickest method to achieve castrate levels of circulating testosterone is orchiectomy.
Androgen-independent (hormone refractory) prostate cancer is defined as clinical and/or PSA progression that occurs despite androgen deprivation therapy.
The median time to death following the documentation of androgen- independent disease is 12–16 months.
