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Urol Clin North Am. 2006 May;33(2):161-6, v-vi.

Combined androgen blockade: an update.

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Division of Urology, Sunnybrook and Women's College Health Sciences Centre, University of Toronto, Toronto, Ontario M4N 3M5, Canada.


The use of combined androgen blockade therapy in prostate cancer management remains controversial. This article reviews the effect of the different non-steroid androgens in blocking androgen-independent activation of the androgen receptor in the androgen-depleted environment, and the potential benefit of bicalutamide in comparison to the first generation of anti-androgens (flutamide and nilutamide). An estimate of the benefit of combined therapy with bicalutamide suggests there is a high probability that bicalutamide 50 mg as combined therapy provides a survival advantage over castration alone. This treatment must be balanced against the potential for an increase in side-effects and a consequent adverse effect on the patient's quality of life.

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