Controversies of Androgen Ablation Therapy for Metastatic Prostate Cancer

Ever since Huggins and Hodges won a Nobel Prize in 1966 for their work describing the relationship between testosterone and prostate cancer, androgen deprivation has continued to be an important component in the treatment of prostate cancer. Refinements in the therapy have occurred in the past 50 years, yet controversies still exist. This review details the controversies and advances in androgen deprivation for prostate cancer including: neoadjuvant androgen deprivation, combined androgen blockade, early versus late androgen deprivation treatment, intermittent versus continuous androgen deprivation monotherapy, anti-androgen monotherapy, anti-androgen and 5-alpha reductase inhibitor combinations, androgen deprivation with periodic intravenous bisphosphonate infusions, and androgen deprivation in conjunction with chemotherapy.