Hormone therapy for prostate cancer: results of the Veterans Administration Cooperative Urological Research Group studies

Abstract

Between 1960 and 1975, the Veterans Administration Cooperative Urological Research Group conducted a consecutive series of 3 major randomized clinical trials comparing various endocrine treatments for newly diagnosed prostate cancer patients. Six major conclusions concerning hormonal treatment emerged from these studies: 1) increased hazard of cardiovascular death after therapy with 5 mg diethylstilbestrol (DES); 2) orchiectomy plus DES no better than orchiectomy or DES alone; 3) equivalent effect of 1.0 and 5.0 mg DES on cancer; 4) reduced cardiovascular hazard from therapy with 1.0 mg DES; 5) Premarin and Provera no better than 1.0 mg DES at doses studied; 6) decisions about hormone treatment at diagnosis dependent on patient characteristics, mainly age and Gleason grade. In this paper, these studies are reviewed briefly and data are presented to support these conclusions. Some tentative treatment recommendations are proposed.