Optimal hormonal therapy for advanced prostatic carcinoma

Although the clinical presentation of stage D2 (M+) prostate cancer is decreasing because of screening, we are witnessing a new spectrum of advanced disease. According to our concept of incurable or advanced prostate cancer, more than half of currently diagnosed prostate cancer patients are potential candidates for hormonal therapy. Hormonal therapy has been the mainstay of treatment for advanced phases of prostate cancer for more than 50 years. However, the optimal form of this therapy is still an enigma. The choice of hormonal therapy for carcinoma of the prostate depends not only on the desired progression-free and overall survival, but also on the patient's quality of life, treatment costs, and treatment toxicities. At present, several important questions have been raised over the optimal treatment modalities for advanced prostate cancer. This review discusses some of the current challenges in the hormonal management of advanced prostate cancer.