or removal of the ovaries for premenopausal patients, and progestins , androgens , Cytadren , estrogens or
  tamoxifen for postmenopausal patients. Hormonal manipulation may be especially useful for those with
  predominantly bone metastases.
• If metastases involve vital organs or are life-threatening, chemotherapy combinations similar to those used in
  earlier stages are given. Again, the risk of Adriamycin-induced cardiac toxicity may limit the amount of drug
  that can be given.

Five-Year Survival  10 percent 

Investigational 
• All patients are candidates for clinical trials , which may involve new drugs in Phase I, II or III trials, new
  biologic agents, autologous bone marrow transplantation (ABMT), treatment with monoclonal antibodies , or
  high-dose chemotherapy with growth factor (such as G-CSF) support. The use of ABMT for advanced
  disease shows some early promise (20-25 percent after two years) but the final role of ABMT is uncertain.