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

Med Hypotheses. 1998 Sep;51(3):243-51. doi: 10.1016/s0306-9877(98)90083-4.

Abstract

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.

MeSH terms

  • 5-alpha Reductase Inhibitors
  • Adenocarcinoma / drug therapy
  • Adenocarcinoma / pathology
  • Aged
  • Androgen Antagonists / economics
  • Androgen Antagonists / therapeutic use*
  • Antineoplastic Agents / economics
  • Antineoplastic Agents / therapeutic use*
  • Enzyme Inhibitors / therapeutic use
  • Humans
  • Male
  • Neoplasm Staging
  • Prostatic Neoplasms / drug therapy*
  • Prostatic Neoplasms / pathology

Substances

  • 5-alpha Reductase Inhibitors
  • Androgen Antagonists
  • Antineoplastic Agents
  • Enzyme Inhibitors