I have heard that hormone therapy might be used for patients with prostate cancer. What types of hormone therapies available and when are they used?

Leonard Gomella, MD

Academic Title: Professor

Chair, Department of Urology

Board Certifications:
Urology

First, a little bit about prostate cancer and hormones. About 60 years ago it was discovered that the prostate gland grows under the influence of male hormones such as testosterone, most of which is produced by the testicles. Likewise, when the prostate gland turns cancerous, testosterone feeds the growth of the cancer much like a fertilizer. This discovery lead the way to so called "hormonal therapy" of prostate cancer. While historically the female hormone estrogen was given to men with prostate cancer to slow the growth of metastatic tumors, this type of hormonal treatment is not commonly used today. The main job of the estrogen was to turn off the testicular production of the male hormone testosterone. Another approach that is uncommon today is the surgical removal of the testicles that causes a reduction in the circulating levels of testosterone.

Today, the main way that testosterone levels are reduced is through medications, usually in the form of a shot. These shots turn off the testicular production of testosterone and depending on the speficif medication used the shots can be given monthly, or every 3,4 or 6 months. An implant that goes under the skin can also be used that works for a year.

When patients have prostate cancer that has spread beyond the prostate to areas such as the bones and lymph nodes, hormonal therapy is usually the first line of treatment. Occasionally hormonal therapy may be used along with other treatments such as radiation to improve the outcomes.