American Board of Internal Medicine (ABIM) Certification Practice Exam

What is a standard treatment approach for metastatic prostate cancer?

1. Surgery followed by radiation

2. Chemotherapy alone

3. Radiotherapy with androgen deprivation therapy

4. Observation without treatment

The correct answer is: Radiotherapy with androgen deprivation therapy

The standard treatment approach for metastatic prostate cancer typically involves combining radiotherapy with androgen deprivation therapy (ADT). This approach targets the cancer's growth, as prostate cancer often relies on testosterone to progress. Radiotherapy can help control and alleviate symptoms from bone metastases, which are common in metastatic prostate cancer, while ADT reduces the levels of testosterone, which can lead to a decrease in the cancer's growth and progression. This combination has been shown to improve survival rates and enhance the quality of life for patients. The other treatment options mentioned have specific contexts or may apply to localized prostate cancer or individual situations, but they do not represent the standard of care for metastatic disease. Surgery followed by radiation is more typical for localized cancer, and chemotherapy alone is usually reserved for cases where there is significant progression despite ADT. Observation without treatment is typically recommended only for certain patients with low-volume or less aggressive disease, prioritizing quality of life over immediate intervention.