Clinical basics: Prostate cancer 10. Palliative care

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The caseA 72-year-old man with no significant illnesses apart from his prostate cancer visits his urologist for follow-up. His prostate cancer was diagnosed 6 years earlier and was treated with radical local therapy. He was well for 3 years, then experienced relapse with bone metastases and pain. Treatment consisted of bilateral orchidectomy, and his symptoms were controlled for 24 months. As the disease progressed, anti-androgen therapy was started. However, over the past 6 months, the symptoms and level of disease, as indicated by prostate-specific antigen, have been increasing, despite withdrawal of the anti-androgen, spot irradiation and a regimen of cytotoxic chemotherapy. The patient is aware that he cannot be cured but wants to ask his physician about complementary therapies, such a green tea and Essiac, and he wants to know what more can be done for him.

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