Is delayed treatment justified in carcinoma of the prostate?

We report a retrospective survey of 263 patients with prostate cancer presenting between 1975 and 1979, with a minimum follow-up period of 5 years. We have evaluated the effects of anti-cancer therapy on survival and disease-free interval. The mean survival time of all patients was 39.6 months. Of 91 patients (37.7%) with demonstrable bone metastases at presentation, 64 (70.3%) have died of prostatic cancer, the mean duration of survival being 25 months. There was no difference in terms of response to treatment or of duration of symptom-free life between patients treated by immediate hormone manipulation and those in whom treatment was delayed. Of 115 patients without metastases at presentation, 42 (36.5%) received no anti-cancer treatment. Thirty-seven (32.2%) have died of unrelated causes and 39 (33.9%) are alive and well. Neither survival nor subjective response to treatment was adversely affected by delaying treatment.