Deferred therapy in patients with advanced disease

Disease that is known to have extended beyond the prostatic capsule is unlikely to be cured by radical surgical excision, although the primary tumor may be controlled by external irradiation. The development of progressive (metastatic) disease is common and may be retarded by hormonal therapy. The timing of such treatment and the debate about monotherapy versus total androgen ablation has not been resolved fully. It is considered further in this article.