The effectiveness of hormone therapy will depend on how much cancer is in your body and how high the prostate specific antigen (PSA) level was before treatment was started.⁵ The higher the amount of cancer in the body, the less effective the treatment will be. If the PSA level ranges from 0.0 to 0.1 ng/ml, the hormone therapy should be effectively working.⁶ However, research indicates the faster the PSA level drops and the longer it stays down, the better the outcome.⁷

Campbell ’s Urology, 7th ed.1998

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What side effects are typical for this type of therapy: Hot flashes, breast tenderness/enlargement, possible impotency, reduced sex drive, diarrhea, nausea/vomiting, or tiredness. Long term use may cause liver damage or bone loss.⁸

Who makes a good candidate: Hormone therapy is often used for men whose cancer has spread to other parts of the body or has come back after earlier treatment.⁹

There are several types of hormone therapy:

Orchiectomy is a permanent, surgical procedure to remove the testicles. It is performed as an outpatient procedure at a hospital or outpatient facility, and patients are able to go home a few hours later. It is called a hormone therapy because it works by removing the main source of male hormones.¹⁰

Luteinizing hormone-releasing hormone (LHRH) analogs are drugs that reduce the amount of testosterone a man produces in his testicles. It is basically a copy of a naturally occurring hormone in the body that stimulates the production of testosterone. These drugs may be delivered via injection at one-, three-, four-, or six-month intervals, or alternatively via a once-yearly implant. This form of therapy is reported to be as effective as orchiectomy.¹¹

Antiandrogens are drugs that block the cell’s ability to absorb the androgens a man’s body produces. However, a small amount of androgens are still secreted by the adrenal glands. Patients take these drugs in pill form, once or three times daily. Sometimes they are used with orchiectomy or LHRH analogs in a combination called total androgen blockade. Antiandrogens are intended to be taken for the rest of your life.¹²

Secondary hormone therapy includes less commonly used drugs, such as megestrol acetate (Megace), medroxyprogesterone (Depo-Provera), and ketoconazole (Nizoral).¹³

In the past, diethylstilbestrol was the main form of hormonal treatment for prostate cancer. These other types of hormone therapy have now replaced this drug.¹⁴

Intermittent hormonal therapy is used because some doctors believe constant exposure to hormonal drugs might promote resistance and recommend intermittent treatment as an alternative. With intermittent therapy, hormonal drugs are stopped after a man’s blood PSA level drops to a very low level and remains stable for a pre-determined amount of time. If the PSA level begins to rise, the drugs are started again.¹⁵