Hormone therapy for prostate cancer

The main purpose of hormone therapy for prostate cancer is to either lower the amount of hormones that are produced in a man’s body, or stop the cancer cells from using these hormones. That’s why it is sometimes referred to as “androgen deprivation therapy” or “androgen suppression” therapy.

Certain male hormones—such as androgens that are primarily produced in a man’s testicles—can cause prostate cancer cells to grow. Testosterone is a type of androgen that affects the growth of prostate cancer cells.

While hormone therapy for prostate cancer may help slow down the growth of prostate cancer cells, or may shrink the cancer, it is not considered to be a cure. It is sometimes used before surgery or in combination with radiation.

It also may be used if surgery or radiation fail, and a man’s cancer comes back, or if a man’s cancer has spread outside the prostate gland, and cannot be cured by surgery or radiation alone. That’s because it can target prostate cancer throughout the body.

Because prostate cancer often becomes resistant to long-term hormonal therapy, treatment may be stopped for periods of time, and then started again. The effectiveness of hormone therapy for prostate cancer is usually monitored by PSA testing.

Types of hormone treatment for prostate cancer

Luteinizing hormone-releasing hormone analogs/agonists: these drugs cause a drop in the amount of testosterone that is produced in the testicles. They are usually either injected with a needle or implanted under the skin. They are generally taken every month or at different intervals that can range from every 3 months to every year.

Luteinizing hormone-releasing antagonists: this newer type of injected drug also works to stop the production of testosterone in the testicles. Because it can cause a serious allergic reaction, it is generally only used for men who have troubling symptoms of advanced cancer and cannot use other forms of hormonal therapy.

Antiandrogens: these are oral drugs (pills) that block a man’s body from being able to use androgens, such as testosterone. They may be used in combination with the other therapies.

Estrogens: these are also sometimes used, particularly if androgen deprivation therapy stops working (which happens sometimes). Estrogens stop testosterone from being produced in a man’s body, but they can cause other potential health risks, such as blood clots.

P450 enzyme inhibitors: these work to help lower testosterone and androgen levels. They may also help work against prostate cancer cells.

Some drugs that are commonly used to fight fungal infections may also be used to help block the production of androgens.

Another approach actually involves a surgical procedure called orchiectomy, where a man’s testicles are surgically removed.

In some cases, these therapies may be combined.

Potential side effects

One side effect that can be frustrating (for both men and their loved ones) following hormone therapy for prostate cancer is that men may have little or no desire for sex.

Other side effects of hormone treatment for prostate cancer can include impotence, hot flashes, sore or swollen breasts, weight gain, tiredness, constipation, dizziness, and depression.

Other medical problems that can develop include osteoporosis, anemia, and decreased muscle mass. The risk of cardiovascular problems, including high blood pressure, high cholesterol, and heart attacks can rise. A man’s risk of getting diabetes also may increase.

When men first use luteinizing hormone-releasing hormone analogs/agonists, they may experience a rise in testosterone levels, which is called a tumor flare. This may cause bone pain in men who have cancer that has spread to the bone, or spinal chord compression if the cancer has spread to the spine.

Always discuss everything you read on this web site with a qualified medical professional.

Updated 6/09



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