Hormone Treatment for Prostate Cancer

Hormone therapy: Because testosterone is known to stimulate growth of prostate cancer cells, anti hormonal therapy is frequently used to treat prostate cancer. Hormone therapy either uses drugs to stop the production of the male sex hormones or the entire source of the hormone is surgically stopped by removing the testicle (orchidectomy).

Occasionally, both types of treatment are used.Hormonal therapy is most effective in men with advanced prostate cancer. The treatment does help to slow the growth and frequently shrinks the tumor. Because this therapy is effective in shrinking tumors, hormonal therapy is frequently used in the early stage of prostate cancer — often in combination with radiation and surgery.

Once the tumor size is downsized, surgery or radiation therapy can be used to destroy whatever tumor is left behind. Also available are drugs which prevent the release of signals from the brain to manufacture testosterone (LH-RH agonists). These longer acting drugs are injected every 2-3 months. The drugs can be continued for a prolonged time without undue side effects.

In the past decade, other anti testosterone drugs have become available in the treatment of prostate cancer. These medications include flutamide (Eulexin), bicalutamide (Casodex) and nilutamide (Nilandron). They can be taken orally and can be combined with LH-RH agonists.

Drug therapy, however, is not ideal for the treatment of prostate cancer. After a few years, most cancer cells develop mechanisms to resist these drugs and develop alternative mechanisms for survival. To prevent the development of drug resistance, intermittent hormone therapy programs have been developed. The PSA levels are monitored and once the levels start to drop, the drugs are stopped. If the PSA levels rise, the drugs are re-started again.