Advanced prostate cancer: immediate or deferred hormone therapy?

The timing of hormone therapy in patients with advanced prostate cancer remains controversial. Although evidence from the Veterans Administration Cooperative Urological Group (VACURG) data indicated the potential benefit of immediate hormone treatment in terms of time to progression and disease-specific survival, it also supported the possibility of deferred treatment. This review looks at the results of subsequent studies of immediate versus deferred hormone therapy including the Medical Research Council (MRC) study, the European Organisation for Research and Treatment of Cancer (EORTC) studies, the Radiation Therapy Oncology Group (RTOG) study and the Eastern Cooperative Oncology Group (ECOG) study. Data from these studies and the availability of newer, better tolerated hormone therapies may well mean that the survival and welfare of patients with advanced prostate cancer could be considerably better with immediate hormone therapy rather than deferred treatment.