Dilemmas in managing prostate carcinoma (Part II): Metastatic disease.

: All newly diagnosed patients should be evaluated for ureteral obstruction and impaired renal function. Partial ureteral obstruction frequently responds to androgen suppression therapy. Most patients eventually have significant pain, usually due to bone destruction from metastases. Pharmaceutical palliation is usually required. Drug intervention should be on a regular schedule--avoid prn dosage of pain medications.