Managing prostate cancer: the role of hormone therapy

Androgen deprivation therapy has been the mainstay of treatment for men with metastatic prostate cancer and now plays a more active role in the management of less advanced cancers as neoadjuvant and adjuvant treatment. Investigative uses include primary therapy for patients unsuitable for definitive therapy and as a complement to ablative procedures, brachytherapy, and chemotherapy. Intermittent androgen deprivation therapy is being considered as an alternative to continuous therapy and further evaluated as triple androgen blockade in conjunction with finasteride. Many accepted and potential management schemes incorporating hormonal therapy are increasingly employed despite indeterminate indications for use. Here, we review currently available data on the efficacy of hormonal therapy with regard to complete androgen ablation, primary, neoadjuvant, and adjuvant therapy. Additionally, we examine the usefulness of delayed versus immediate administration, intermittent androgen deprivation, and other prospective applications for hormonal therapy.