Hormone Suppression Therapy for Prostate Cancer

Hormone suppression therapy is a treatment that can help to slow the growth of cancer cells in the prostate (prostate gland). It is also called androgen deprivation therapy (ADT).

Hormone suppression therapy targets hormones in the body called androgens that may help cancer cells grow. This therapy reduces the amount of these hormones in the body or keeps the body from using them.

Hormone suppression therapy alone will not cure prostate cancer, but it can slow the growth of prostate cancer and may shrink tumors over time. Your health care provider can help you find the most effective way to treat your type of prostate cancer and best fit your lifestyle.

Types of hormone suppression therapy

Orchiectomy

Orchiectomy, also called surgical castration, is a surgery to remove one or both testicles. The testicles are where the two main androgens (testosterone and dihydrotestosterone) are made.

Medicine therapy

Medicine therapy, also called chemical castration, involves taking medicines to keep your body from making or using androgens. If you choose this therapy, you may take any of these medicines:

• Luteinizing hormone-releasing hormone (LHRH) agonist medicines. These medicines are injected or implanted under your skin to lower the amount of androgens that your testicles make. If you take these medicines, you may also be prescribed other medicines to help with side effects. Common LHRH agonist medicines include:
  • Leuprolide.
  • Goserelin.
  • Histrelin.
  • Triptorelin.
• LHRH antagonist medicines. These medicines are like LHRH agonist medicines but they work faster. They are commonly used to prevent side effects when prostate cancer is in an advanced stage. A common LHRH antagonist medicine is degarelix.
• CYP17 inhibitor medicines. These medicines help to stop other glands from making androgens. They may be used if the prostate cancer is advanced and has not gotten better with surgery or other medicine treatment. A steroid medicine may be given with this type of medicine to help with side effects. A common CYP17 inhibitor medicine is abiraterone.

Anti-androgen medicines

Anti-androgen medicines block areas on the body where androgens attach. This prevents the androgens from coming into contact with cancer cells and fueling their growth. These medicines include:

• Flutamide.
• Bicalutamide.
• Enzalutamide.
• Nilutamide.

Androgen-suppressing medicines

Androgen-suppressing medicines may be used if other hormone suppression treatments are not working. They are not commonly used, however, because of their side effects. These medicines include:

• Estrogen.
• Ketoconazole.

What are the risks?

Hormone suppression therapy may cause side effects, including:

• Hot flashes.
• A decrease or lack of sexual desire.
• Erectile dysfunction (impotence).
• A decrease in the size of the penis or testicles.
• Breast tenderness.
• An increase in breast size.
• Fatigue.
• Weight gain.
• Thinning of the bones (osteoporosis).
• Anemia.
• Loss of muscle.
• Depression.
• Increased cholesterol levels.
• Trouble with thinking or focusing.
• Stomach upset and nausea.
• Diarrhea.

Hormone suppression therapy can also increase your risk of these problems:

• High blood pressure (hypertension).
• Stroke.
• Diabetes.
• Heart attack.
• Heart disease.

What are the benefits?

One of the main benefits of hormone suppression therapy is having additional treatment options. You may have only one type of treatment or two or more types at the same time. Treatments may be combined to:

• Help with side effects.
• Treat advanced cancer.
• Avoid treatments that may cause physical or emotional distress.

Hormone suppression therapy may be used during any stage of prostate cancer treatment.

Contact a health care provider if:

• You have pain or side effects that do not get better with treatment.
• You have trouble urinating.
• You have new side effects that do not go away.

Get help right away if:

• You have severe chest pain.
• You have trouble breathing.
• You have an irregular heartbeat.
• You have numbness or paralysis in the lower half of your body.
• You are confused.
• You have trouble talking or understanding.

These symptoms may be an emergency. Do not wait to see if the symptoms will go away. Get medical help right away. Call your local emergency services (911 in the U.S.). Do not drive yourself to the hospital.

Summary

• Hormone suppression therapy is a treatment that can help to slow the growth of cancer cells in the prostate (prostate gland).
• Hormone suppression therapy alone will not cure prostate cancer, but it can slow the growth of prostate cancer and may shrink tumors over time.
• Treatment to suppress hormones may include surgery or medicines.