A 65-year-old man comes to the physician for a follow-up. He underwent prostatectomy for prostate cancer one year ago. After surgery, his serum prostate-specific antigen (PS A) concentration was 1 ng/mL. Initial staging evaluation revealed no evidence of metastatic disease. PSA level is now 8 ng/dL, and repeat imaging reveals regional lymphadenopathy. The patient is prescribed combination therapy with buserelin and bicalutamide. Which of the following is the main reason for adding bicalutamide to this patient's treatment regimen?

Question

A 65-year-old man comes to the physician for a follow-up. He underwent prostatectomy for prostate cancer one year ago. After surgery, his serum prostate-specific antigen (PS A) concentration was 1 ng/mL. Initial staging evaluation revealed no evidence of metastatic disease.  PSA level is now 8 ng/dL, and repeat imaging reveals regional lymphadenopathy.  The patient is prescribed combination therapy with buserelin and bicalutamide.  Which of the following is the main reason for adding bicalutamide to this patient's treatment regimen?

Quizplus · Accepted Answer

Eductional Objective: Because prostate cancer is an androgen-dependent tumor, patients with advanced disease are generally treated with surgical or medical orchiectomy.  Medical orchiectomy uses GnRH analogues to reduce LH production, which subsequently reduces androgen production in the testes.  Because there is an initial surge in androgens at the start of therapy (due to stimulation of the GnRH receptor), patients prescribed GnRH therapy are usually treated with a few weeks of androgen-receptor inhibitors (eg, bicalutamide).

A 65-Year-Old Man Comes to the Physician for a Follow-Up