Initially, when first used by Huggins and Hodges hormone therapy (ADT) was recommended to be used early on in prostate cancer disease progression.
Eventually, the Veterans Administration Cooperative Urology Research Group (VACURG) studies reversed this early recommendation. After this study ADT was usually deferred until symptomatic progression. It was believed that ADT caused an alteration of the nature of metastatic lesions, thereby creating earlier androgen resistance.
Recently this debate has again come into issue. Earlier use of ADT has gained new and stronger popularity because of the advent of less-toxic and well-tolerated pharmaceutical agents, such as luteinizing hormone-releasing hormone (LHRH) agonists and antiandrogens. Laboratory studies have demonstrated that early hormone therapy does not confer early resistance. An update of the VACURG study by Byar and Corle determined that disease progression from stage C to stage D was decreased from 50% to 10% with diethylstilbestrol (DES) therapy.