Table of Contents

Chapter 6: Using Hormone Therapy

Prostate cancer cells are just like all other living organisms—they need fuel to grow and survive. Testosterone, a hormone that is responsible for what we consider the typical male characteristics such as body hair growth and increased muscle mass, is also the main fuel for prostate cancer cell growth and is therefore a common target for therapeutic intervention in men with prostate cancer.

Treatment regimens that fall into this category are commonly known as "hormone therapy" or "hormonal therapy," but should really be called "anti-hormone therapy." The goal is to stop testosterone from being released or to prevent the hormone from acting on the prostate cells. (An alternative name for this treatment, androgen deprivation therapy, or ADT, probably offers the most accurate description.)

In past decades, men with localized prostate cancer were treated with surgery or radiation therapy, and only came back to their doctors for additional treatment, specifically hormone therapy, if they experienced pain or other symptoms indicating that their cancer had recurred and had metastasized, or spread to other areas of the body. In fact, the shift from early-stage to advanced prostate cancer is often characterized by the need for systemic therapies, or those that work throughout the whole body instead of just at the local tumor site, in order to keep the disease under control. The use of hormone therapy in men with metastatic prostate cancer has been the standard of care for over 60 years. However, more and more researchers are finding that the lines between local and systemic treatments are blurred, and that some men with early disease might benefit from hormone therapy either before, during, or after local treatment.

In this Chapter, we’ll review the ways in which different hormone therapy options can be used in men with prostate cancer. As we’ll see, because the process by which testosterone affects cell growth has multiple steps, researchers have identified a number of different drugs and surgical options that can be used effectively.But remember that no one approach is right or wrong. Be sure to discuss the different options with your doctor so you can find the approach that’s right for you.