BACKGROUND: Management of metastatic @entity263 continues to evolve. The widespread use of the @entity1486 (PSA) assay has led to earlier diagnosis and earlier detection of recurrent disease. Debates continue regarding the proper use and timing of endocrine therapy with orchiectomy, @entity172 agonists, @entity4396 ( @entity4396 ) analogs, @entity4396 antagonists, and @entity342 antagonists. METHODS: The authors reviewed the significant published materials of the last 20 years that have shaped hormonal management of metastatic and progressive @entity263 . Major areas of controversy were also identified. RESULTS: The present approach to hormonal management is summarized. Five potential pathways to the development of @entity342 -independent @entity263 are described. Controversial topics of hormonal management, including immediate vs delayed hormonal therapy, monotherapy vs maximal @entity342 blockade (MAB), and intermittent hormonal therapy, are discussed. CONCLUSIONS: Orchiectomy, @entity172 agonists, and @entity4396 analogs have therapeutic equivalence. @entity1 who have a rising PSA after definitive treatment for @entity263 and high risk of recurrent disease may warrant early @entity342 deprivation. MAB does not appear to be significantly better than single-agent @entity4396 analog therapy. Intermittent therapy may delay emergence of @entity342 independence and maintain or improve quality of life.

Controversies surrounding @entity342 deprivation for XXXX .

@entity172 :: ('MESH:D004967', 'Chemical') :: ['estrogen'] @entity4396 :: ('2796', 'Gene') :: ['luteinizing hormone-releasing hormone', 'LHRH'] @entity1 :: ('9606', 'Species') :: ['Patients'] @entity263 :: ('MESH:D011471', 'Disease') :: ['prostate cancer'] @entity342 :: ('CHEBI:50113', 'Chemical') :: ['androgen'] @entity1486 :: ('354', 'Gene') :: ['prostate-specific antigen']
@entity263 :: (MESH:D011471,Disease) :: ['prostate cancer']
