Hormone Therapy for Prostate Cancer

Hormone therapy, sometimes called “androgen deprivation therapy,” is one of the primary treatment options for prostate cancer.

What should you know about this important option?

What Is It and How Does It Work?

Your body produces a variety of hormones throughout your life. Some of these hormones are produced in much higher levels in men and are called androgens. Testosterone is the most well-known androgen. Androgens are made primarily in the testicles, but the adrenal glands located on top of the kidneys also produce a small amount.

Androgens have been shown to cause prostate cancer cells to grow. The basic premise or idea behind androgen deprivation therapy is to block the production or effects of androgens on the body and, thus, to slow or stop the growth of prostate cancer cells.

How Can the Production of Androgens Be Stopped?

The production of androgens takes place mostly in the testicles. There are a couple of ways that this production can be almost completely stopped.

• Orchiectomy  Orchiectomy is a surgery that involves the removal of both of the testicles. Obviously, once the testicles are removed, they are no longer able to produce androgens.
  Orchiectomy is different from other options for two key reasons. First, the procedure results in a permanent effect. There is no way to reverse it once completed. Second, there is an obvious physical change after completing the surgery.
  For these reasons, many men choose one of the non-surgical androgen deprivation options.
  
• Luteinizing Hormone-Releasing Hormone (LHRH) Agonists and Antagonists These two groups of drugs (with complicated sounding names) work by blocking the hormones that cause androgens to be produced. They typically work just as well as orchiectomy at lowering testosterone levels in the body.
  They are administered via implants under the skin or as injections. Common drugs in this category include leuprolide, goserelin, triptorelin, and abarelix.
  These drugs have become more popular than orchiectomy in recent years, but are more expensive and require frequent visits to your physician.

How Can Androgens Be Blocked From Working?

Anti-androgen medications also exist that do not stop the production of androgens, but, instead, block their function in the body. These are typically used after orchiectomy or while LHRH agonists or antagonists are being used. They are rarely used alone.

Anti-androgens block the function of androgens throughout the body regardless of whether the androgen was made in the testicles or adrenal glands. Anti-androgens are usually given as a pill that is taken every day.

Common medications in this category include flutamide (Eulexin) and bicalutamide (Casodex).

What Are Some of the Options That Are Not Used Much Anymore?

You may have heard that estrogens used to be used to block the effects of male hormones in the body. That is true, but they are rarely used today.

Unfortunately, estrogens were found to significantly increase your chances of developing some important complications including blood clots. Because of this, they fell out of favor. Today, they are used only in specific situations where other more common hormone therapies have lost their effectiveness and other options are needed.