Life after failure of traditional androgen deprivation therapy.

Castrate resistant prostate cancer is a disease state which, counterintuitively, can be successfully treated with additional therapy directed at inhibition of androgen synthesis and/or interfering with the activity of the androgen receptor. Novel androgen biosynthesis inhibitors and antiandrogens are now being tested in large phase 3 clinical trials to clarify their role in the treatment of men who have failed traditional medical castration, with or without currently available nonsteroidal antiandrogens. A renewed interest in studying parenteral delivery of estrogens may provide evidence to revisit the initial medical therapy for advancing prostate cancer.