Controversies Surrounding Androgen Deprivation for Prostate Cancer

Stephen G. Patterson, MD, Lodovico Balducci, MD, Julio M. Pow-Sang, MD

Disclosures

Cancer Control. 2002;9(4) 

In This Article

Conclusions

Orchiectomy, estrogen agonists, and LHRH analogs produce equivalent clinical responses in advanced prostate cancer. Castration remains the frontline treatment for metastatic prostate cancer. Patients who have undergone definitive local treatment for prostate cancer but have a rising PSA are candidates for initiation of hormonal therapy. For the majority of men with a standard risk of recurrent disease, early hormone treatment should be performed only in the sitting of a randomized clinical trial. MAB does not appear to be significantly more effective than single-agent LHRH analog. Prescription of an antiandrogen during the first month of treatment with an LHRH analog should be considered, but prolonged MAB beyond 1 month is not superior to LHRH analog monotherapy. Castration produces detrimental effects on the musculoskeletal, endocrine, cardiovascular systems, libido, and potency. Intermittent hormonal therapy may delay progression to the hormone refractory state and lengthen survival.

This article was originally certified for CME credit. For accreditation details, contact the publisher.
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