Because testosterone serves as the main fuel for prostate cancer cell growth, it’s a common target for treatment. Hormone therapy (also called androgen deprivation therapy or ADT) is part of the standard of care for advanced and metastatic prostate cancer. ADT is designed to either stop testosterone from being produced or to directly block it from acting on prostate cancer cells. Although hormone therapy is effective at controlling prostate cancer growth, the loss of testosterone has side effects in nearly all men. These side effects range from hot flashes and loss of bone density to mood swings, weight gain, and erectile dysfunction. The timing of when to start hormone therapy once the PSA begins to rise is an individual decision and one that should be discussed with your doctor.
For a man starting hormonal therapy, doctor visits are usually timed to include the hormone therapy injections (which lower your testosterone), along with PSA and other lab checkups such as testosterone levels and liver and kidney function tests.
The majority of prostate cancer cells will die or stop growing once they are deprived of testosterone. However, in many men, some cells gain the ability to grow in the low-testosterone environment created by hormone therapy. As these hormone therapy-resistant prostate cancer cells continue to grow, hormone therapies have less and less of an effect on the growth of the tumor over time. This state is also referred to castration-resistant prostate cancer (CRPC). Despite this potential pitfall, ADT remains an important step in the process of managing advanced disease, and it will likely be a part of every man’s therapeutic regimen if he develops metastatic disease at some point during his fight against recurrent or advanced prostate cancer.
Learn more about the types of hormone therapy.
Other Uses of Hormone Therapy
Although ADT has always played an important role in men with advanced metastatic prostate cancer, it is also increasingly being used in combination with radiation therapy because studies have shown that this combination increases long-term survival.
Hormone Therapy with Radiation
Hormone therapy is often given together with radiation therapy for localized disease (note: it is also used alone or in combination with other treatments for men with metastatic prostate cancer).
Hormone therapy usually consists of a shot that lowers your testosterone, given every 1 to 6 months, depending on the formulation. Sometimes, it is prescribed as a daily pill that blocks testosterone from reaching the cancer cells. Clinical trials show a benefit in patients who receive hormonal treatment in combination with external beam radiation. Hormone therapy has been shown to improve cure rates of prostate cancer for men receiving radiation therapy and is part of the standard of care for men with certain types of intermediate-risk prostate cancer and nearly all high-risk prostate cancer. It is often given for intermediate-risk cancer for 4 to 6 months (called short-term hormone therapy), and for 2 to 3 years in men with high-risk localized prostate cancer, although some doctors may recommend as little as 18 months of hormone therapy.
Hormone therapy should not be given to men with low-risk prostate cancer and is not a standalone treatment for localized prostate cancer in any risk category.
Want more information about a prostate cancer diagnosis and treatment options? Download or order a print copy of the Prostate Cancer Patient Guide.