Early versus delayed hormonal therapy in advanced prostate cancer.
OBJECTIVE
To review current thinking on the optimum timing of androgen deprivation in the treatment of patients with advanced prostatic cancer (PCa).


BACKGROUND
Although the beneficial impact of androgen deprivation has been well documented in patients with advanced PCa, a number of questions remain to be answered about the best therapeutic schedule for hormonal therapy. One such important issue is whether androgen deprivation should be introduced at the time of diagnosis or delayed as long as the patient remains asymptomatic.


CONCLUSIONS
For many years urologists have delayed hormonal treatment for patients with advanced PCa, however, this has recently been reassessed. It is now well established that early hormonal treatment significantly delays the onset of disease progression, which may correlate with an improved quality of life. Although several studies indicate that early treatment has a beneficial effect on survival, this has not been definitely proven, and results from further studies are needed before final conclusions can be drawn. However, apart from men wishing to maintain their sexual activity, early androgen deprivation should be proposed in all patients with advanced PCa.
Mazeman
E
E
Department of Urology, University Hospital, Lille, France.
Bertrand
P
P
D000726:Androgen Antagonists / Q000627:therapeutic use; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D003131:Combined Modality Therapy; D006801:Humans; D008297:Male; D009919:Orchiectomy; D011471:Prostatic Neoplasms / Q000401:mortality / Q000628:therapy*; D013997:Time Factors
D000726:Androgen Antagonists; D018931:Antineoplastic Agents, Hormonal