Overview of current status of total androgen deprivation in metastasized prostate cancer.

The incidence and methods available for the diagnosis of metastatic prostate cancer, together with the development and efficacy of various treatments, are discussed. In patients with good prognostic characteristics, maximal androgen deprivation, with blockade of both testicular and adrenal androgens, seems to be the favored approach. Surgical castration, although effective, seems inferior to depot luteinizing hormone-releasing hormone therapy with respect to patients' acceptance and preference. Nonsteroidal antiandrogens, such as flutamide, have advantages over steroidal compounds both in efficacy and side effects. Recent studies have demonstrated that combination therapy may be superior in terms of progression-free survival and overall survival in patients with metastatic prostate cancer.