A new look at an old option in the treatment of early-stage prostate cancer: hormone therapy as an alternative to watchful waiting

• Published in: Medical hypotheses Vol. 51; no. 3; pp. 243 - 251
• Main Authors: Yang, F.E., Song, P.Y., Wayne, J., Vaida, F., Vijayakumar, S.
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Ltd 01.09.1998; Elsevier
• Subjects: 5-alpha Reductase Inhibitors; Adenocarcinoma - drug therapy; Adenocarcinoma - pathology; Aged; Androgen Antagonists - economics; Androgen Antagonists - therapeutic use; Antineoplastic Agents - economics; Antineoplastic Agents - therapeutic use; Biological and medical sciences; Enzyme Inhibitors - therapeutic use; Hormones. Endocrine system; Humans; Male; Medical sciences; Neoplasm Staging; Pharmacology. Drug treatments; Prostatic Neoplasms - drug therapy; Prostatic Neoplasms - pathology; Human; Chemotherapy; Urinary system disease; Treatment; Prostate disease; Antiandrogen; Early stage; Malignant tumor; Male genital diseases; Prostate
• ISSN: 0306-9877; 1532-2777
• DOI: 10.1016/S0306-9877(98)90083-4

Watchful waiting is an attractive option in the management of early-stage, low-grade prostate cancer because of the high financial costs and complication risks associated with surgery and radiotherapy. Despite the drawbacks of current local therapy, neither treatment can demonstrate a discernible survival benefit over observation alone. Even the slowest progressing disease, however, can potentially develop into a deadly medical problem. As a result, physicians and patients frequently have difficulty accepting untreated cancer. Therefore, we propose that another option be considered in cases of prostate cancer that would otherwise qualify for observation alone: the use of two oral hormonal agents, flutamide and finasteride, to achieve complete androgen blockade. Some evidence exists which suggests that such therapy may improve symptom-free survival, and perhaps overall survival as well. This ‘aggressive’ form of ‘conservative’ therapy may satisfy patient concerns that are not adequately addressed by current forms of therapy