Hormone therapy for prostate cancer is also known as
androgen deprivation therapy (ADT).
Prostate cancer cannot grow or survive without
androgens, which include
testosterone and other male hormones. Hormone therapy
decreases the amount of androgens in a man's body. Reducing androgens can slow
the growth of the cancer and even shrink the tumor.
Hormone therapy may be used along with radiation treatment when there is a
high risk of the cancer returning. Or hormone therapy may be used after surgery
or radiation if any cancer remains.
The outlook for men diagnosed with prostate cancer has never been brighter. Doctors now have a variety of ways to treat prostate cancer, including surgery, radiation, and drugs that slow the growth of cancer cells. Both the safety and effectiveness of prostate cancer treatments has been steadily improving.
That’s good news, of course. But with so many different approaches to prostate cancer treatment, each with its own benefits and risks, weighing your options and choosing the most appropriate treatment...
Hormone therapy may also help men who have
cancer that has spread and who cannot have surgery or radiation. It may be used when prostate cancer has spread outside the prostate (metastatic disease). In these cases, hormone therapy reduces pain and helps men live a little longer.1
Hormone therapy may be used to suppress prostate cancer cells, which is reflected in lower levels of prostate-specific antigen (PSA).
Hormone therapy alone is sometimes used as the main treatment for prostate cancer in men who can't have surgery or radiation. But hormone therapy doesn't seem to help men ages 66 and older who have localized prostate cancer. These men live just as long with active surveillance.2
Taking medicine, such as luteinizing hormone-releasing hormone (LHRH) medicine, is one way
to reduce androgens. Another way, used much less often, is surgery to remove
the testicles, also known as an orchiectomy.
LHRH agonists. These
drugs stop the body from making testosterone. They include goserelin (Zoladex),
histrelin (Vantas), leuprolide (Lupron), and triptorelin (Trelstar).
LHRH antagonists. These drugs stop the body from making testosterone. They work right away. And they avoid the flare caused by LHRH agonists, which can make symptoms worse for several weeks. One LHRH antagonist is degarelix (Firmagon).
Androgen inhibitors. These are medicines that block enzymes that the body needs to make testosterone. They include enzalutamide (Xtandi), ketoconazole, and abiraterone (Zytiga), which is given along with prednisone.
drugs often are used along with LHRH agonists. Antiandrogens help block the
body's supply of testosterone. There are steroidal antiandrogens and "pure"
antiandrogens. The steroidal antiandrogens include megestrol (Megace). The
"pure" or nonsteroidal antiandrogens include bicalutamide (Casodex), flutamide, and nilutamide (Nilandron).
Orchiectomy. This surgery is considered to be hormone
therapy. This is because removing the testicles, where more than 90% of the
body's androgens are made, decreases testosterone levels. Removing the
testicles may be the simplest way to reduce androgen levels, but it is permanent.
Sometimes androgen deprivation (orchiectomy or an LHRH
agonist) and an antiandrogen are used together for treatment. This targets the testosterone made by the testicles and the adrenal glands. It is called a
combined androgen blockade (CAB).
Other hormone therapies may include the use of
medicines such as megestrol, estrogen, aminoglutethimide
combined with hydrocortisone, and corticosteroids (prednisone, dexamethasone,