Hormone therapy treatment for prostate cancer is designed to eliminate the male hormones (androgens) from the body. Androgens are necessary for the development and function of the male sexual organs and male sexual characteristics such hair growth and voice changes.
Androgens are primarily produced by the testicles, under control of various parts of the brain. A small amount of androgens is produced by the adrenal glands, which are small glands located above the kidneys and which produce many important chemicals. The most common androgen is testosterone.
Prostate cancer cells may be hormone sensitive, hormone insensitive, or hormone resistant. Cancer cells that are hormone sensitive require androgens for growth. Prostate cancer cells that are hormone resistant continue to grow despite hormone therapy. Therefore hormone therapy for the treatment of prostate cancer only works in the former case.
It is important to note that hormone therapy treatment for prostate cancer does not eliminate prostate cancer cells, but rather it is “palliative therapy” in that its goal is to slow down the progression of prostate cancer. Hormone treatment for early stage prostate cancer, or hormone therapy for patients with metastatic disease may work effectively for several years. However over time, hormone-resistant cells will emerge, and the cancer will grow.
Hormone treatment for prostate cancer may be used as a primary, secondary, or neoadjuvant therapy. Hormone therapy for the treatment of prostate cancer is often used as a primary therapy in older men who are not candidates for surgery or radiation therapy and who are not interested in watchful waiting. It is also used in men who have metastatic disease at the time their prostate cancer is detected.
Men who experience a rise in their PSA after radical prostatectomy, radiation therapy, or cryotherapy are given hormone therapy to slow down the growth of the recurrent prostate cancer. Hormone therapy may be given for a period of time before radical prostatectomy or radiation therapy to shrink the prostate gland and make the procedure easier to perform. This is referred to neoadjuvant therapy.
Hormone treatment for prostate cancer comes with side effects such as fatigue, loss of libido, erectile dysfunction and even osteoporosis. Discuss with your doctor on what to expect, and research for ways to cope with the side effects before you undergo treatment.