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Patients with locally advanced prostate cancer(PCa) are thought to be at a significant risk of death from PCa or development of distant metastases. To improve the prognosis of those patients, a variety of clinical trials with adjuvant and/or neoadjuvant therapies have been performed. In this review, we described a benefit of integrating local and systemic therapies in the management of locally advanced PCa.

Recently, prostate cancer is one of the common cancer in Japanese men, with a high incidence of bone metastasis. Bone metastasis is incurable and contributes significantly to disease-specific morbidity and mortality. And more, there are many opportunity to perform androgen deprivation therapy in prostate cancer patients, but worsen osteoporosis and raise a risk of bone fracture. Thus, the management of bone metabolism in patients is a clinically significant issue. The bisphosphonates are targeted to osteoclasts and are considered to be standard management in the care of bone metastasis patients in combination with chemotherapy and hormone therapy. In this review, we summarized the current understanding and therapy of bone metastasis in prostate cancer in mainly respect to Zoredronic acid use.

Bone metastases of prostate cancer usually have an underlying osteoclastic component. Bone metastasis is incurable and contributes significantly to disease-specific morbidity and mortality. Management of bone metabolism in patients is a clinically significant issue. Several key factors have been found to be important in tumor-induced promotion of osteoclast activity. Receptor activator of nuclear factor-kappa B ligand (RANKL) is produced by bone metastasis of prostate cancer, enabling these metastasis to induce osteolysis through osteoclast activation. Matrix metalloproteinases (MMPs) are secreted by prostate cancer cells and promote osteolysis primarily through degradation of bone matrix. In this way, many factors derived from prostate cancer metastases can promote osteolysis, and these factors may serve as therapeutic targets. The new agents are targeted to osteoclasts (i.e.: zoledronic acid, anti-RANKL monoclonal antibody, cathepsin K inhibitor, and anti-PTHrP monoclonal antibody), are considered to be standard management in the care of bone metastasis patients in combination with chemotherapy and hormone therapy. In this review, we summarized the current understanding and therapy of bone metastasis in prostate cancer.

Androgens play an important role in human many organs. However, the serum levels of androgens are decreasing with aging. Currently, synthesized androgens are used for several diseases. In this review, we mentioned about the clinical use of these androgens.