Surgical castration by orchidectomy

Surgical castration is the manner simplest and cheaper to treat the metastatic cancer of prostate. The obvious disadvantage is the psychological effect of the loss of the testicles.

LHRH-analogues

the LHRH-analogues and the oestrogen realize has medical castration by stopping the testiculaire production testosterone. the LHRH-analogues are injections which must be given monthly or quarterly for the remainder of the patient of the 'life of S. They are effective but very expensive.

Oestrogen

The oestrogen can be taken orally daily. It has a high incidence of the complications thrombotic such as the race and the myocardial infarction.

Anti-androgens

the Anti-androgens are opposed to the action testosterone by blocking the receivers of androgen. The incidence of the erectile dysfunction is less than with the surgical or medical orchidectomy because testosterone levels are maintained in blood circulation. only the Anti-androgens are probably not with treatment proportioned for the metastatic disease. The total blockade of androgen by a combination of the st�ro�daux anti-androgens and LHRH-analogues or orchidectomy did not prove to be better than only LHRH-analogues or the orchidectomy. However, the anti-androgens non-steroidal gives results slightly better than only castration.

The disease locally advanced without metastases

The total results of the treatment of the patients presenting the disease beyond the prostate are not good. Some patients presenting the first disease beyond the capsule prostate sufferer, and no obviousness of metastases, favours radical treatment. The modes of treatment usually most employed are composed of a combination of the radiotherapy and hormonal treatment.

Options of treatment for the disease locally advanced and metastatic

• Hormonal treatment early.
• Attentive waiting with the hormonal treatment once the symptoms develop.

The disease which deviated with the seminal blisters and over there is not true setting.

The cancer of prostate depends on male testosterone of hormone. 80% of patients will react to the hormonal treatment which deprives the tumour of testosterone. This answer implies usually the contracting of metastases and the symptomatic improvement for the patient. The answer to the hormonal treatment is not a treatment but can last during many years in some patients. The intermediate duration of the answer is 2 years. The majority of cancers escape hormonal handling thereafter. This indicated under the name of the disease independent of hormone and is usually followed death in a few months.

The polemic exists concerning the synchronization of the hormonal treatment. The majority of the studies indicate an advantage of survival for early rather than late the hormonal operation. The deprivation of testosterone has side effects like the dysfunction, the enlarging of centre and the osteoporosis �rectiles. The hormonal treatment earlier is instituted more the possibility of the complications is large. The treatment must be individualized again with the needs for the specific patient.

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