March 16, 2009 -- Question: Why don't more men choose surgical castration for prostate cancer?
Answer: Surgical castration is really still a very effective way of treating prostate cancer and it does remove the source of testosterone immediately. When the drugs that act at the pituitary level became available 25 years ago or so men were offered the choice of surgical castration versus taking shots, and not surprisingly, really for psychological reasons, most men chose to take shots. But the net effect is the same. That is, testosterone drops, there's loss of libido, and some of the other side effects. But it's irreversible. And the one thing that is allowed with medical castration using the drugs is intermittent therapy.