Androgen receptor assays in advanced prostatic cancer

Prostatic cancer remains the most common malignant disease in men. Approximately 70,000 cases are clinically diagnosed each year, and three to eight times that number are detected incidentally at the time of autopsy. As the third highest cause of cancer deaths among men, this disease claims approximately 27,000 lives each year. At this time, there are no techniques that allow for the formulation of prognosis and selection of therapeutic alternatives in stage D prostatic cancer. Measurement of prostatic tumor hormone levels, AR content, or multidiscriminatory parameters may yet be demonstrated useful in this regard. However, the greatest hindrance to the success of any of these assays may well be unavoidable clinical and biologic features inherent in prostatic cancer. Material for biopsy is available infrequently for analysis from osseous and deep lymphatic metastases. By the time metastases have developed, the primary tumor in the prostate may have already been treated. The prostate primary may contain an admixture of benign prostatic hypertrophy. The heterogeneity of prostatic cancer may interdict against the accuracy of any biochemical assay. At the present time there is insufficient evidence that any biochemical test yet available will allow for accurate prognostication and selection of treatment in stage D prostatic cancer.