Hormonal therapy: the benefits of postponed initiation.

Although the efficacy of antiandrogen therapy is universally recognized in patients with prostatic adenocarcinoma, the dosage and timing of endocrine intervention remain controversial. Deferred anti-androgen therapy is advocated in asymptomatic patients with advanced prostatic cancer, primarily because of the palliative nature of this therapy and the attendant side effects of decreased libido, gynecomastia, or the cardiovascular morbidity associated with estrogen administration. Methodology may soon be available clinically for identification of patients with androgen-dependent tumors to maximize the effectiveness of treatment.