Hormonal ablation therapy for metastatic prostatic carcinoma: a review.

Hormonal therapy is the standard treatment for metastatic prostatic carcinoma. The conventional surgical or medical androgen ablation therapy seems to have a similar response. Despite a higher response of CAB compared to conventional castration in metastatic disease, the controversy of survival benefit remains unsolved. Immediate treatment should be given in metastatic disease particularly in patients who have minimal metastases. In patients who have progression after CAB, antiandrogens should be withdrawn. The choices of optimal therapies for prostate cancer depend not only on the survival but also the quality of life and cost effect. Thus, the critical factors for approaching prostate cancer are appropriate patient selection and stratification. Implicit with this approach should maximize benefit from maximal androgen ablation therapy for patients who are likely to profit from it. Finally, the development of experiments, clinical trials, and novel therapeutic strategies may provide better management for prostate cancer in the future.