Hormone Therapy and Chemotherapy
Androgen Deprivation Therapy (Hormone Therapy)
Male hormones (called androgens), particularly testosterone and dihydrotestosterone, determine male secondary sex characteristics and stimulate prostate cell growth. When prostate cells, both healthy and cancerous, are deprived of androgens, they no longer proliferate and eventually die.
Androgen deprivation therapy (also called androgen suppression therapy or hormone therapy) uses drugs or surgery to suppress or block male hormones, particularly testosterone and dihydrotestosterone, which stimulate the growth of prostate cells. Androgen deprivation therapy is not a cure for prostate cancer, but it can help control symptoms and disease progression.
Androgen deprivation therapy is used for advanced and metastatic cancer and may be used if treatment for localized prostate cancer has failed and cancer recurs (as indicated by rising PSA levels).
There has been some debate about when to start androgen deprivation therapy. The American Society of Clinical Oncology’s (ASCO) clinical guidelines recommend that hormone therapy should, in general, be delayed until patients with recurrent, progressive, or advanced prostate cancer begin to experience symptoms from their cancer. However, when therapy is deferred, patients should regularly visit their doctors every 3 - 6 months for careful monitoring of their condition.
ASCO recommends either removal of both testicles (bilateral orchiectomy) or injections with luteinizing hormone-releasing hormone (LH-RH) agonists as initial androgen deprivation treatments. Combining antiandrogen drug therapy with orchiectomy or LH-RH agonist drugs may also be considered.
When prescribing hormone therapy drugs, some doctors recommend periodically stopping and restarting treatment (intermittent therapy). This approach may possibly help men avoid the loss of sexual function. More research needs to be conducted to determine the effectiveness of intermittent therapy.
Review Date: 07/26/2010
Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.