Hormonal therapy (medical orchiectomy) in prostatic carcinoma

: Hormonal therapy of prostate cancer is still the most effective systemic treatment. Possible alternatives to subcapsular orchiectomy are discussed, comprising the estrogens with their known cardiovascular side effects, the expensive LH-RH analogues, and/or the antiandrogens, which depend on the patient's compliance. Due to more intensive health care and more sensitive diagnostic methods, there is now an increase not only in the overall number of diagnosed prostate carcinomas, but also in the percentage of those which do not need treatment. The question when, and in which patient hormonal treatment should be started becomes increasingly important.