Medical therapy of prostate carcinoma

Medical treatment of prostatic cancer is one of the most complex and challenging issues in oncologic urology, and probably of oncology itself. In fact, in spite of the well known sensitivity of the disease to hormonal manipulations, it is still substantially unclear whether hormonal therapy achieves survival improvement. Furthermore, many prostate cancers become hormone refractory within 18 to 36 months from the onset of therapy, and until now, no further treatment has been able to improve their prognosis, in spite of the often promising early results. Medical treatment is now being used as an adjunct to radical surgery and to radiotherapy, in both the adjuvant and the neoadjuvant setting, and this raises further controversies. This paper is an attempt to give to the readers the state of art of medical therapy, even within the limits of a concise review. The authors are aware of these limits but hope that this paper can be useful to the reader.