Hormone therapy to treat prostate cancer
Some cancers can’t be treated with surgery and radiation alone.
For advanced prostate cancers (stages III or IV), other options must be considered.
These advanced treatments target the whole body.
If your cancer has spread beyond the prostate gland (stage III), it cannot be stopped
with a local treatment. Hormone therapy may slow its advance.
Hormone therapy targets testosterone.
Hormone therapy fights prostate cancer by cutting off the supply of the male hormones
(androgens)—especially
testosterone—that encourage prostate cancer growth. Hormone control can
be achieved by surgery to remove the testicles (orchiectomy or castration) or through
the use of drugs that shrink the cancer.
Hormone therapy can affect cancers that have spread beyond the prostate gland. Hormone
therapy is also helpful in alleviating the painful and distressing symptoms of advanced
prostate cancer. Although hormone therapy cannot cure cancer, it will usually shrink
or halt the advancement of the disease, often for years at a time.
A variety of hormone drugs can produce medical castration by cutting off the supply
of testosterone:
- Luteinizing hormone-releasing hormone (LHRH) analogs: Taken as
injections, LHRH analogs lower the amount of androgens the testicles produce. These
drugs are the most common agents for lowering the levels of testosterone in the
body
- Female hormones (estrogens): These block the release and activity
of testosterone. However, because of possible side effects, they are no longer used
as widely to treat prostate cancer
- Antiandrogens: These block the activity of any androgens
Some studies seem to indicate that combinations of hormone therapies have similar
effectiveness to a single hormone treatment. Unfortunately, hormone
therapy works for nearly all prostate cancers only for a limited time.
Hormone therapy can be given before surgery or radiation.
Given prior to surgery, neoadjuvant hormone therapy often helps to shrink a tumor.
Sometimes hormone therapy is used after radiation or surgical therapy to reduce the risk of cancer coming back.
Hormone therapy can come with side effects.
Either surgical castration or medical castration can produce a striking response.
However, depending on the type of therapy, the drug or procedure can cause:
- Hot flashes
- Erectile dysfunction or impotence
- Decreased sex drive (libido)
- Breast enlargement or tenderness
- Cardiovascular problems
- Weight gain
- Weakening of bones (osteoporosis)
- Malaise and fatigue (extreme tiredness)
Managing side effects
Return to top