Patients with advanced prostate cancer have a beneficial effect from maximal androgen blockade in terms of the subjective and objective delay of progression and median duration of survival, although side effects do occur more often in the combination treatment than in testicular suppression alone. Significant improvement or delayed deterioration in subjective parameters such as metastatic pain, performance status and urinary disorders strongly suggest (in the absence of validated questionnaires of quality of life at the time of this study) that orchiectomy plus nilutamide improves the quality of life as assessed by the subjective delay of progression, according to NPCP criteria, to an extent which outweighs the majority of adverse events.