¹Department of Urology, Royal Free Hospital, London, UK

Correspondence: AV Kaisary, Royal Free Hospital, Pond Street, London NW3 2QG, UK. E-mail: amir.kaisary@btinternet.com

Received 10 March 2005; Accepted 23 March 2005; Published online 26 April 2005.

Abstract

This article evaluates the use of early hormonal therapy in patients with localised or locally advanced prostate cancer. In patients receiving radiotherapy, an overall survival benefit is proven for adjuvant goserelin ('Zoladex') in locally advanced disease. Adjuvant to radical prostatectomy, castration (goserelin or orchiectomy) has demonstrated an overall survival benefit in patients with lymph node metastases. Survival advantages have not yet been proven with nonsteroidal antiandrogens, but immediate or adjuvant bicalutamide ('Casodex') improves objective progression-free survival in patients with locally advanced disease, with certain quality-of-life advantages over castration.