[Cancer of the prostate: subcapsular orchiectomy]

More than 80% of prostatic cancers are detected at stage C or D., so that barely 10% are "curable". The positive effect of hormonal palliative treatment depends on the hormono-dependence of the tumor. Of all types of hormonal treatment, sub-albugineal castration remains one of the best. The authors report a series of 42 patients: 33 previously treated by hormones (estrogens or antiandrogens) and 9 never treated before. All were metastatic. Bone metastatic pain disappeared in 68% of the cases after castration. After failure of hormonal treatment castration relieved pain in 62% of the cases and controlled local tumoral spread in 56%. Hormone manipulation does not prolong the patients survival. Castration is as efficient as drugs and has no side effects. It should be undertaken when clinical discomfort or ureteral obstruction appears and not before. Hormonal drug therapy does not help when the effects of castration have worn off.