Carcinoma of the prostate: the therapeutic dilemma.

The management of prostatic carcinoma remains confusing; however, recent studies indicate that treatment selection should be based upon the anatomic extent of disease. Disease that is confined within the anatomic limits of the prostate is best treated by surgically removing the gland. Disease that extends outside of the anatomic confines of the prostate is managed with difficulty and the optimum treatment is as yet undetermined. Disease that is symptomatic and involves distant sites is apparently best treated initially by androgen deprivation and then by multiagent chemotherapy if this fails.