[Unresolved questions in hormonal therapy for prostate cancer]

Although there still are unresolved questions in hormonal therapy for prostatic cancer patients, it has long been considered one of the major therapeutic modalities after the report by Dr. Huggins in 1941. The unresolved questions are: "Can hormonal therapy for prostatic cancer prolong the survival of the patients?" "Can hormonal therapy improve the quality of life of prostatic cancer patients?" "Is complete androgen blockade superior to androgen reduction therapy?" "Is pre-operative hormonal therapy more beneficial than post-operative hormonal therapy?" and "How do we handle relapsed prostatic cancer?" We, urologists, unanimously recognize the beneficial effects of hormonal therapy in most prostatic cancer patients, even in a rather short span. Furthermore, other therapeutic modalities, except radical prostatectomy or radical radiation, can not eradicate cancer cells from patients. We can not treat prostatic cancer patients leading to better outcomes without hormonal therapy. Thus, hormonal therapy is chosen in most of the prostatic cancer patients as a first line therapy. Each type of hormonal therapy for prostatic cancer has specific characteristics, with advantages and disadvantages. We must choose the best hormonal therapy in terms of cost-benefit and quality of life during the therapy.