Castration-recurrent prostate cancer is not androgen-independent

In the USA in 2006, an estimated 234,460 new cases of prostate cancer (PC) will be diagnosed and 27,350 men will die from PC (1). Despite the increased use of digital rectal examination and serum prostate-specific antigen (PSA) measurement for early detection,? 30% of men treated with curative intent suffer PC recurrence. These men and those who present with locally advanced or metastatic PC can be palliated by androgen deprivation therapy (ADT), a treatment that remains unimproved since its discovery more than 60 years ago (2). Over 80% of men with disseminated PC demonstrate clinical or biochemical response that is associated with a mean life expectancy of ? 3.5 years in contrast to nonresponders or untreated patients who live an average of 9 months. Regardless of the androgen responsiveness of incurable PC, almost all patients succumb to castration-recurrent PC because it responds poorly to all known therapies.