For patients who relapse, palliative radiotherapy may be recommended to ease discomfort where the relapse is in the pelvis and the patient has not had previous radiotherapy here, but the patient is now incurable and therapy is directed to symptoms. For relapses outside the pelvis or those patients presenting with stage 4 disease ab initio, then occasionally, progestogen therapy (e.g. medroxyprogesterone) may give some worthwhile remissions and will be prescribed in most cases at least for a trial period. Cytotoxic chemotherapy has had a poor track record in this disease, but occasionally will be offered on a carefully audited trial. Interestingly, some (around 10%) of patients presenting with stage 4 disease live five years.
Plowman Oncology London (e-mail: postmaster@pnplowman.demon.co.uk)
