Prostate cancer will affect 1 in 9 men, according to the American Cancer Society. After skin cancer, prostate cancer is the most common cancer diagnosed in men in the U.S. For Black men, the numbers are even more dire: Our men are 1.7 times more likely to be diagnosed with prostate cancer than white men, and 2.2 times more likely to die from it.
The type and stage of your cancer, as well as your overall health and preferences, will help you and your health care provider choose the most appropriate treatment plan. Options may include active surveillance, surgery, radiation therapy, hormone therapy, cryosurgery, chemotherapy and biological therapy.
Most prostate cancer cells rely on testosterone to help them grow. Hormone therapy for prostate cancer, also called androgen deprivation therapy, is a treatment to stop testosterone from being produced or reaching prostate cancer cells.
Your doctor may recommend hormone therapy for prostate cancer as an option at different times and for different reasons during your cancer treatment.
Hormone therapy can be used:
- In advanced prostate cancer to shrink the cancer and slow the growth of tumors, which also might relieve signs and symptoms
- After treatment of prostate cancer, if your PSA level remains high or starts rising
- In locally advanced prostate cancer, to make radiation therapy more effective in reducing the risk of recurrence
- In those with a high risk of recurrence after initial treatment
Side effects of hormone therapy for prostate cancer can include:
- Loss of muscle mass
- Increased body fat
- Loss of sex drive
- Erectile dysfunction
- Bone thinning, which can lead to broken bones
- Hot flashes
- Decreased body hair, smaller genitalia and growth of breast tissue
- Changes in behavior
- Problems with metabolism
To minimize the side effects of hormone therapy, your doctor may recommend you take them for certain periods of time or until your PSA is very low. You might need to resume these medications if the disease recurs or progresses.
Early research shows this intermittent dosing of hormone therapy medications may reduce the risk of side effects. However, we need additional studies to determine the long-term survival benefits of intermittent therapy.
Your doctor might suggest intermittent dosing if you have an elevated level of PSA in your blood, but no other evidence of spreading cancer.
As you consider hormone therapy for prostate cancer, discuss your options with your doctor. Approaches to hormone therapy for prostate cancer include:
- Medications that stop your body from producing testosterone. Certain medications—known as luteinizing hormone-releasing hormone or gonadotropin-releasing hormone agonists and antagonists—prevent your body’s cells from receiving messages to make testosterone. As a result, your testicles stop producing testosterone.
- Medications that block testosterone from reaching cancer cells. These medications, known as anti-androgens, usually are given in conjunction with LHRH agonists. That’s because LHRH agonists can cause a temporary increase in testosterone before testosterone levels decrease.
- Surgery to remove the testicles. Removing your testicles reduces testosterone levels in your body quickly and significantly. But unlike medication options, surgery to remove the testicles is permanent and irreversible.
You’ll meet with your cancer doctor regularly for follow-up visits while you’re taking hormone therapy for prostate cancer. Your doctor will ask about any side effects you’re experiencing. Many side effects can be controlled.
Depending on your circumstances, you may undergo tests to monitor your medical situation and watch for cancer recurrence or progression while you’re taking hormone therapy. Results of these tests can give your doctor an idea of how you’re responding to hormone therapy, and your therapy may be adjusted accordingly.