Brian P. Schmitt, MD

Androgen suppression, primarily castration, has been the key objective of treatment of metastatic prostate cancer. Surgical castration, achieved by the use of bilateral orchiectomy, produces a short-term symptomatic and objective tumor response in 70% to 80% of patients.[1] Medical castration, by the use of leuteinizing hormone-releasing hormone (LHRH) agonists, produces an almost equivalent effect. However, use of medical or surgical castration eliminates only 90% to 95% of the daily testosterone production. The remainder is produced in the adrenal glands.