Abstract
Department of Medicine, Division of Endocrinology, P.O. Box 850, The Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033 increase life expectancy and to relieve symptoms. If treatment were to be advocated in asymptomatic patients, the therapy should improve the length of patient survival. Rigorously controlled series from the Veterans Administration Cooperative Urological Research Group (VACURG) trials during the 1960s indicated no clear survival benefit from endocrine therapy at the time of diagnosis. Since then, standard practice involves withholding hormonal therapy until metastatic (stage D) disease is present. Patients with stage Al disease are observed, and patients with stage A2 and B tumors are treated either with radical prostatectomy or radiation therapy. Stage C patients receive radiation therapy, although some clinicians advocate initiating hormonal therapy for these patients before the development of symptoms (2, 3). Prospective randomized trials are required to determine the optimal management of stage C disease, and this remains an area of some controversy. Prostate Cancer
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