American Society of Clinical Oncology recommendations for the initial hormonal management of androgen-sensitive metastatic, recurrent, or progressive prostate cancer Review uri icon


MeSH Major

  • Antineoplastic Agents, Hormonal
  • Neoplasm Recurrence, Local
  • Palliative Care
  • Prostatic Neoplasms


  • A full discussion between practitioner and patient should occur to determine which therapy is best for the patient. Bilateral orchiectomy or luteinizing hormone releasing hormone agonists are the recommended initial treatments. Nonsteroidal antiandrogen therapy may be discussed as an alternative, but steroidal antiandrogens should not be offered as monotherapy. Patients willing to accept the increased toxicity of combined androgen blockage for a small benefit in survival should be offered nonsteroidal antiandrogen in addition to castrate therapy. Until data from studies using modern medical diagnostic/biochemical tests and standardized follow-up schedules become available, no specific recommendations can be issued regarding the question of early versus deferred ADT. A discussion about the pros and cons of early versus deferred ADT should occur.

publication date

  • December 2004



  • Review



  • eng

Digital Object Identifier (DOI)

  • 10.1200/JCO.2004.04.579

PubMed ID

  • 15184404

Additional Document Info

start page

  • 2927

end page

  • 41


  • 22


  • 14