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Since 1985, ketamine, a frequently used human and veterinary anaesthetic, has been listed as an essential medicine by the World Health Organization. This N-methyl-d-aspartate receptor antagonist has also been used and studied extensively for its role in the treatment of depression. Owing to its potential implications on health when used illicitly, at least 60 countries have already put ketamine under national control. Its illicit use has been reported on a global scale, so are its delirious complications from chronic abuse. The detrimental effects of ketamine abuse encompass different organ systems, where long-lasting complications on the genitourinary, gastrointestinal, hepatobiliary and neuropsychiatric systems stood out. In this relatively new entity of ketamine-associated complications, the importance of proper assessment and building of good rapport is emphasized. Abstinence is the first key for the successful management of its complications. Both medical and surgical management have its role in the multidisciplinary management.

Aim To evaluate the progression-free survival (PFS), cancer-specific survival (CSS) and overall survival (OS) of Chinese metastatic prostate cancer patients following primary androgen deprivation therapy (ADT) in relation to prostate-specific antigen (PSA) nadir level. Methods All Chinese prostate cancer patients with bone metastases who were treated with primary ADT from 2000 to 2009 were included. Patients' and disease characteristics were recorded. Patients were categorized into two PSA nadir groups (≤1.0 and >1.0 ng/mL). Associations of PSA nadir with PFS, CSS and OS were analyzed with Kaplan–Meier and Cox regression analyses. The survival outcomes of the two PSA nadir groups were presented. Results Four hundred nineteen patients were included in the study. PSA nadir appeared to be a good predictor for PFS (hazard ratio [HR] 1.86, 95% confidence interval [CI] 1.35–2.56, P 1.0 ng/mL, the median PFS were 15 and 10 months, and the 1-year PFS rates were 64% and 40%, respectively; the median CSS were 42 and 27 months, and the 5-year OS rates were 53% and 28%, respectively; and the median OS were 41 and 24 months, and the 5-year OS rates were 45% and 19%, respectively. Conclusions Higher PSA nadir was associated with shorter PFS, CSS and OS in Chinese metastatic prostate cancer patients following primary ADT. The survival outcomes may serve as references in deciding the best treatment strategy in Chinese prostate cancer patients.