Endocrine therapy for prostate cancer.

Endocrine therapy of prostate cancer has mostly been reserved to patients with advanced stages of the disease. The principle for endocrine treatment of prostate cancer is elimination of stimulatory effects of testicular androgens on the prostate tumour cells. This can be achieved by surgical removal of the testes, by inhibition of pituitary gonadotrohin secretion by GnRH-angonsists or antagonists, by oestrogens or by non-steroidal antiandrogens. Since non-steroidal antiandrogens have fewer side-effects than castrational therapies, there is an increased interest for using endocrine treatment as adjuvant therapy after localized treatment. At least in certain stages of the disease, early hormonal treatment may have survival benefits. The timing of endocrine therapy, the usage of combined androgen blockade and intermittent endocrine therapy will be discussed in this overview.