Treatment

Hormone therapy

Hormone therapy treats prostate cancer by stopping the hormone testosterone from reaching the prostate cancer cells.

Testosterone is produced by the testicles and adrenal glands. One of its roles is to control the development and growth of the sexual organs, including the prostate gland. Normal levels of testosterone do not usually cause any problems, but if there are cancer cells in the prostate gland, testosterone can cause them to grow faster. In other words, testosterone 'feeds' the prostate cancer. If testosterone is taken away, the cancer cells shrink, wherever they are in the body.

Hormone therapy alone will not get rid of your prostate cancer but it can keep it under control for many months or years before you and your doctor may need to consider additional treatment options. It can also be used with other treatments to help make them more effective.

What other treatments are available?

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Who can have hormone therapy?

Hormone therapy is a treatment option for many men with prostate cancer, but it is used in different ways depending on the stage of your cancer. Speak to your doctor or nurse about your individual treatment options.

You can read more about how hormone therapy is used for each stage of prostate cancer in our online fact sheet.

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What types of hormone therapy are there?

LHRH agonists
These drugs stop the brain from telling your body to make testosterone and are given by injection or as a small implant inserted under the skin. There are several different LHRH agonist drugs. Some of the common ones are:

  • goserelin (brand names: Zoladex, NovGos)
  • leuprorelin acetate (brand name: Prostap)
  • buserelin acetate (brand name: Suprefact)
  • triptorelin (brand names: Decapeptyl, Gonapeptyl Depot).

GnRH antagonists
At the moment, there is only one kind of GnRH antagonist called degarelix (brand name Firmagon).This type of drug is given by injection and is only available in some hospitals.

Surgery to remove the testicles (orchidectomy)
This type of hormone therapy involves an operation, called an orchidectomy, to remove the testicles, or just the parts of the testicles that make testosterone. Without testosterone, the prostate cancer cells are not able to grow.

Anti-androgens
These are tablets that stop testosterone from reaching the cancer cells. There are several different anti-androgens, including:

- bicalutamide (one brand name is Casodex)
- flutamide
- cyproterone acetate (one brand name is Cyprostat).

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What are the advantages and disadvantages?

There are specific advantages and disadvantages to the different types of hormone therapy.

Read more about the advantages and disadvantages of hormone therapy.

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What does treatment involve?

The type of hormone therapy you have will depend on the stage of your cancer, the other treatments you are having and your own personal preferences. You may have more than one type of hormone therapy at the same time.

Depending on which type of hormone therapy you have, you may visit the hospital or your GP surgery for treatment. You will have regular prostate specific antigen (PSA) blood tests to help check how well your treatment is working. You may like to ask your specialist how often you will have a PSA test.

Your doctor, nurse of GP will also monitor any side effects you have from your treatment and other symptoms.

Your specialist team may suggest different ways of using hormone therapy, such as combined androgen blockade and stopping and starting hormone therapy (intermittent hormone therapy). You can read more about this in our online fact sheet.

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What happens afterwards?

Hormone therapy will be a life-long treatment for many men with prostate cancer. Your original hormone therapy may keep your prostate cancer under control for many months or years.

However, over time the behaviour of your cancer cells may change and your cancer may start to grow again. Although the prostate cancer is no longer responding to your original type of hormone therapy, it may still respond to other types of hormone therapy or a combination of other treatments.

You can read more about treatments for prostate cancer that is no longer responding to your original hormone therapy in our Tool Kit fact sheet, Second line hormone therapy and further treatment options.

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What are the side effects?

Like all treatments, hormone therapy has a risk of side effects. All types of hormone therapy can cause side effects, including surgery to remove the testicles (orchidectomy). The side effects are caused by lowered testosterone levels.

It is important to discuss the possible side effects with your doctor or nurse before you start any treatment. If you know what side effects to expect it can make it easier to cope with them.

Hormone therapy affects different men in different ways. The risk of getting each side effect depends on which treatment you are having and how long you have it for. If you are concerned about side effects speak to your doctor or nurse or call our confidential Helpline.

The most common side effects of hormone therapy are:

  • Loss of sex drive (libido) and erectile dysfunction
  • Hot flushes
  • Bone thinning
  • Breast swelling and tenderness
  • Tiredness (fatigue)
  • Weight gain
  • Strength and muscle loss
  • Risk of diabetes, heart attack and stroke
  • Changes to your memory and concentration
  • Changes to your mood

You can find more detailed information about all these side effects and ways to help manage or reduce them on our side effects page.

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Questions to ask your doctor or nurse

  • What is the aim of treatment?
  • What type of hormone treatment are you recommending for me and why?
  • How often will I have follow-up appointments?
  • How long will it be before we know if the hormone therapy is working?
  • What are the possible side effects?
  • What other treatments are available if the cancer starts to grow again?
  • What will happen if I decide to stop my treatment?

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References

You can find a full list of references used to produce this page in our online fact sheet.

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