Progression, defined as two consecutive increases in total PSA following the achievement of a nadir PSA or the development of new or worsening lesions on bone scans or soft tissue lesions (based on RECIST criteria), showed no significant differences between subcapsular orchiectomy and medical ADT.14,17,19 This phenomenon can be attributed to the shared objective and mechanism of action of both modalities, as androgen suppression drives the progression control of prostate cancer in both approaches. This evidence concerns the gene KLK3 and prostate carcinoma.