Comparison of Total Androgen Blockade and Orchiectomy in Metastatic Cancer of Prostate
Total androgen blockade, which consists of the inhibition of action of all androgens, has been described (1). On the basis of an open clinical trial, it was claimed that total androgen blockade gives much better results than simple testicular androgen ablation in metastatic prostate cancer and that it represents the only acceptable form of treatment of that disease (2). In order to test this claim, which is not supported by all investigators (3), a double-blind, randomized study comparing these two modes of treatment was initiated. Testicular androgen suppression is usually obtained by the administration of estrogens or LHRH agonists, or by orchiectomy. We feel that this last method is the safest, the simplest and the most reliable. It is independent of patient compliance and has no unexpected side effects or serious complications. It also avoids the possible flare which may have a deleterious effect (4–6). The suppression of action of other androgens at the level of the prostatic cell is obtained by administration of an antiandrogen (7–9).
KeywordsPlacebo Estrogen Flare Assure Androgen
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