EARLY VERSUS DELAYED HORMONAL-THERAPY IN ADVANCED PROSTATE-CANCER

Objectives: To review current thinking on the optimum timing of androg en deprivation in the treatment of patients with advanced prostatic ca ncer (PCa). Introduction: Although the beneficial impact of androgen d eprivation has been well documented in patients with advanced PCa, a n umber of questions remain to be answered about the best therapeutic sc hedule for hormonal therapy. One such important issue is whether andro gen deprivation should be introduced at the time of diagnosis or delay ed as long as the patient remains asymptomatic. Conclusions: For many years urologists have delayed hormonal treatment for patients with adv anced PCa, however, this has recently been reassessed. It is now well established that early hormonal treatment significantly delays the ons et of disease progression, which may correlate with an improved qualit y 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 c an be drawn. However, apart from men wishing to maintain their sexual activity, early androgen deprivation should be proposed in all patient s with advanced PCa.