**1. Introduction**

336 Prostate Cancer – Diagnostic and Therapeutic Advances

Ellis, GK. Bone, HG. & Chlebowski, R. (2008). Randomized trial of denosumab in patints

Fizazi, K. Carducci, M. Smith, M. Damiao, R. Brown, J. Karsh, L. Milecki, P. Shore, N. Rader,

prostate cancer: a randomised, double-blind study. *Lancet* 377 (68): 813-22.

*Clinical Oncology* 26: 4875-82.

receiving adjuvant aromatase inhibitors for non-metastatic breast cancer. *Journal of* 

M. Wang, H. Jiang, Q. Tadros, S. Dansey, R. & Goessl, C. (2011). Denosumab versus zoledronic acid for treatment of bone metastases in men with castration-resistant

> Since 1941, when Huggins and Hodges proved the favourable effect of surgical castration and oestrogen administration on the progression of metastatic prostate cancer (PCa) (1,2), androgen deprivation therapy (ADT) became the mainstay of management of advanced PCa till now. They demonstrated for the first time the responsiveness of PCa to androgen deprivation.

> ADT effectively palliates the symptoms of advanced disease, significantly reduces tumor growth, but there is no conclusive evidence at present that it prolongs survival. Moreover, significant amount of data report that ADT is associated with several adverse effects. The most prominent include: loss of bone mineral density (BMD), which leads into increased fracture risk (3), induction of insulin resistance (4), unfavorable changes in serum lipid profile (5), changes in body composition (6) which can lead into increased cardiovascular morbidity (7) and changes in cognitive functions (8).

> The aim of ADT is to cause severe hypogonadism, and adverse effects of ADT clearly demonstrate the essential and pluripotent role of male´s most important androgen – testosterone (TST).
