Secondary Hormone Treatment
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Introduction

Several secondary hormonal treatments have clinical activity and the sequential use of these may lead to prolonged periods of clinical response. Secondary hormonal therapies can provide a safe and effective treatment option in patients with rising PSA despite a castrate testosterone level. The use of steroids and adrenal androgen suppressors, such as ketoconazole, aminoglutethimide and (recently) abiraterone, has resulted in symptomatic improvement and a greater than 50% PSA decrease in a substantial percent of patients. A similar clinical benefit has been demonstrated with estrogen based therapies. Other agents are in clinical trials that may provide more complete blockade of testosterone.

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