The combination of LH-RH analogues with other treatment modalities in prostate cancer

Androgen deprivation is the mainstay of therapy for prostate cancer. LHRH agonists are an essential part of this form of treatment and may be employed as the only endocrine manipulation, or in combination with antiandrogens, i.e., maximal androgen blockade. In patients with bone metastases, maximal androgen blockade prolongs life for 3-6 months. The patient with minimal metastatic spread, however, may benefit much longer from this combination. In addition to being used permanently, maximal androgen blockade may be given intermittently. In locally advanced prostate cancer, LH-RH analogues, alone or together with antiandrogens, are presently being studied in conjunction with radical surgery or definitive irradiation. Whether such a neoadjuvant or adjuvant use postpones the time to progression has not yet been decided. The patient with lymph node metastases seems to benefit from early androgen deprivation in conjunction with radical prostatectomy, if the primary tumor is diploid.