Early Hormonal Therapy for Prostate Cancer: The Good, the Bad, and the Ugly

[摘要] Hormonal deprivation therapy has been the most avidly used treatment for advanced prostate cancer since its first description by Huggins and Hodges in 1941,1 a discovery for which Dr. Huggins shared the Nobel Prize in Medicine in 1966. Since that time, great controversy has arisen regarding the optimal timing for the initiation of hormonal therapy. Today, because of prostate-specific antigen (PSA) screening and early detection, patients are diagnosed much earlier than in the past, resulting in a long natural history of disease before the development of metastasis or death. Indeed, among men with a biochemical failure after radical prostatectomy, the median time to developing metastasis is 8 years and the median time to death an additional 5 years.2 Clearly, hormonal therapy can affect quality of life.3 Therefore, within this context, when is the best time to begin hormonal therapy, and is that timing the same for all men? Two recently published articles shed light on which patients might benefit and which actually might be harmed from early hormonal therapy. Finally, a third article reminds us that hormonal therapy, although a very potent antitumor agent, exacts a cost.

[学科分类] 基础医学