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Maximum androgen blockade in advanced prostate cancer

A recent manuscript in the Lancet, overviewed the published literature on either testicular suppression of androgen production (by orchidectomy – removal of the testes - or LHRH analogues, which medically have the same effect, by down regulating the testicular stimulatory hormones from the pituitary) or this plus an anti-androgen drug taken orally (e.g. flutamide, bicalutamide or nilutamide)- a treatment that has acquired the nickname of: Total Androgen Blockade or TAB, - in the therapy of metastatic prostate cancer.
 
This overview of all the studies has shown a tiny 2-3% 5 year survival advantage in favour of both modalities being given at once; it is unlikely that the small size of this difference in favour of TAB will convince all oncologists to recommend this over orchidectomy (surgical of medical) alone.