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Hormone Therapy for Advanced Prostate Cancer continued...

If you become resistant to hormone therapy or have problems with side effects, your doctor may try "intermittent therapy." This means you'll have the drugs for a while, then go off, then go on again. This can improve your quality of life and make the hormone therapy more effective.

Newer types of hormone therapy include:

  • Abiraterone acetate (Zytiga), a pill that stops prostate cancer cells (and other cells) from making androgens. It's approved for men with advanced prostate cancer who have tried other hormone therapies.
  • Enzalutamide (Xtandi), a pill that blocks cells from receiving androgens. It's approved for men with advanced prostate cancer who have tried other hormone therapies and the chemo drug docetaxel.

Surgery to Remove the Testicles (Orchiectomy)

Your testicles make most of your testosterone. Surgery to remove the testicles (called an orchiectomy) is a type of hormone therapy because it quickly cuts testosterone levels.

This operation used to be common, but most men with prostate cancer don't get it any more. Instead, they take medicines that lower hormone levels while leaving the testicles in place.

If you do get the surgery, it's an "outpatient" procedure, which means you won't have to stay in the hospital. Your doctor may also give you anti-androgen therapy.


If hormone therapy stops working, your doctor may suggest immunotherapy. It uses your immune system to attack the cancer cells.

Sipuleucel-T (Provenge) is used to treat advanced prostate cancer. To make it, the doctor removes white blood cells from your blood. These go to a lab, where experts genetically engineer them to fight your prostate cancer. You then get these cancer-killing cells by IV injection in three separate treatments.

Radiation Therapy

This treatment uses high-energy rays kill cancer cells and shrink tumors. You may get it to shrink your tumors and ease symptoms.

You may get radiation therapy from a machine at a clinic, or through substances doctors put into your body.

If your prostate cancer hasn’t spread beyond your bones, your doctor may consider using the drug radium-223 (Xofigo), along with medicine to lower your testosterone level. You get Xofigo by injection once a month. It binds to minerals in your bones to deliver radiation directly to bone tumors.