Hormone therapy for prostate cancer has come a long way in the past few
decades. Not so long ago, the only hormonal treatment for this disease was
drastic: an orchiectomy, the surgical removal of the testicles.
Now we have a number of medications -- available as pills, injections, and
implants -- that can give men the benefits of decreasing male hormone levels
without irreversible surgery.
Four years ago, Santa gave me the worst Christmas present I'd ever received.
The day after the most joyous holiday of the year, my doctor called and
delivered the news that I had prostate cancer.
Because my dad had prostate cancer decades before, I had been going to a
urologist since I turned 40 to have a PSA [prostate-specific antigen test].
Recently, my PSA had shot up very high, to 29, and the following biopsy
confirmed that I had a highly aggressive tumor. At 50 years old, I faced the
"I think hormonal therapy has done wonders for men with prostate
cancer," Stuart Holden, MD, Medical Director of the Prostate Cancer
Hormone therapy for prostate cancer does have limitations. Right now, it's
usually used only in men whose cancer has recurred or spread elsewhere in the
But even in cases where removing or killing the cancer isn't possible,
hormone therapy can help slow down cancer growth. Though it isn't a cure,
hormone therapy for prostate cancer can help men with prostate cancer feel
better and add years to their lives.
On average, hormone therapy can stop the advance of cancer for two to three
years. However, it varies from case to case. Some men do well on hormone
therapy for much longer.
What Is Hormone Therapy?
The idea that hormones have an effect on prostate cancer is not new. The
scientist Charles Huggins first established this over 60 years ago in work that
led to his winning the Nobel Prize. Huggins found that removing one of the main
sources of male hormones from the body -- the testicles -- could slow the
growth of the disease.
"This procedure worked dramatically," says Holden, who is also
director of the Prostate Cancer Center at Cedar Sinai Medical Center in Los
Angeles. "Before, these men were confined to bed and wracked with pain.
Almost immediately afterwards, they improved."
Huggins found that some types of prostate cancer cells need certain male
hormones -- called androgens -- to grow. Androgens are responsible for male
sexual characteristics, like facial hair, increased muscle mass, and a deep
voice. Testosterone is one kind of androgen. About 90% to 95% of all androgens
are made in the testicles, while the rest are made in the adrenal glands
located on top of the kidneys.
How Does Hormone Therapy Work?
Hormone therapy for prostate cancer works by either preventing the body from
making these androgens or by blocking their effects. Either way, the hormone
levels drop, and the cancer's growth slows.
"Testosterone and other hormones are like fertilizer for cancer
cells," Holden tells WebMD. "If you take them away, the cancer goes
into shock, and some of the cells die."
In 85% to 90% of cases of advanced prostate cancer, hormone therapy can
shrink the tumor.
However, hormone therapy for prostate cancer doesn't work forever. The
problem is that not all cancer cells need hormones to grow. Over time, these
cells that aren't reliant on hormones will spread. If this happens, hormone
therapy won't help anymore, and your doctor will need to shift to a different