The answer to how long they will work is unknown. At the present, no one can predict the duration of response to hormonal therapy. I usually tell men starting hormonal therapy about my most successful patient – who at the time he was diagnosed had cancer spread to his bones and all over his body, and he was not a candidate for surgery or radiation. He was placed on hormonal therapy and his PSA remained undetectable for 19 years. Some men will stay in a remission for long periods of time – 10, 12, or 15 years – and there are other patients for whom the time will be much shorter. The remission time is completely unpredictable in individual patients. If the PSA rises while on Lupron and Casodex, other types of hormones are available and a more effective form of chemotherapy is also available. In the pipeline are new experimental treatments involving immunotherapy, gene therapy. They are not ready for “prime-time” now, but in three to four years from now may offer better and more effective treatments with less side effects than treatments we have now. Eventually, genetic studies will show us which tumors are going to be responsive to hormonal therapy for a long time and which are destined not to respond as well.