Hormone therapy is a common treatment for advanced prostate cancer or cancer that has returned after treatment. Hormone therapy can involve taking medications or surgically removing your testicl*s.
Prostate cancer develops in the walnut-shaped gland in your pelvis that produces fluid to help nourish and transport sperm. Hormone therapy is a prostate cancer treatment that removes hormones that cancer cells need to grow.
Hormone therapy is often used along with other treatments to treat advanced prostate cancer or cancer that has reoccurred after previous treatment.
Read on to learn more about hormone therapy, including how it works, when it’s used, and what side effects it can cause.
Prostate cancer requires male sex hormones called androgens to grow. Hormone therapy lowers levels of androgens in your body to stop the growth of the cancer.
Hormone therapy may involve:
- surgery
- medications
- taking synthetic hormones
Doctors use hormone therapy to treat prostate cancer in the following
- with external beam radiation therapy for stage 2–4 prostate cancer
- with or without radiation therapy for stage 3 prostate cancer
- for stage 4 prostate cancer or prostate cancer that has returned
Researchers are also
Here are some of the types of hormone therapy doctors use to treat prostate cancer.
Orchiectomy
Orchiectomy, or surgical castration, is the permanent removal of your testicl*s. It reduces levels of testosterone in your blood by as much as
Luteinizing hormone-releasing hormone (LHRH) agonists
LHRH agonists work by preventing your pituitary gland from secreting luteinizing hormone (LH). LH stimulates the production of testosterone from your testes. LHRH agonists include:
- leuprolide (Eligard, Lupron Depot)
- buserelin (Suprefact, Suprecur)
- goserelin (Zoladex and others)
Treatment with LHRH is called chemical castration.
LHRH antagonists
LHRH antagonists work by blocking LHRH from binding with your pituitary gland and preventing the production of LH. Two
Antiandrogen therapies
A number of antiandrogen medications may be useful if other treatments aren’t effective.
- androgen receptor blockers, which bind to androgen receptors to block the action of androgen
- androgen synthesis inhibitors to prevent androgen production by your tissues. These medications include:
- abiraterone (Zytiga, Yonsa)
- ketoconazole (Nizoral and others)
- aminoglutethimide (Elipten, Cytadren, Orimeten)
Estrogens
Estrogen can inhibit testosterone production in your testicl*s. However, it isn’t a common treatment due to potential side effects.
Hormone therapy is usually among the first treatments doctors use for advanced prostate cancer. The development of hormonal therapies led to a
Hormone therapy by itself
Hormone therapy can
- low sex drive
- hot flashes
- erectile dysfunction
- loss of bone density or easy fractures
- loss of muscle mass and strength
- changes in your cholesterol levels
- weight gain
- mood swings
- insulin resistance
- fatigue
- development of breast tissues
- increased risk of
cardiovascular disease - diarrhea
- rashes
- itchiness
- liver damage (for the medication flutamide)
Hormone therapy may be administered as a surgery, oral medications, or injections.
Orchiectomy
An orchiectomy is usually performed under general anesthesia to send you to sleep during your procedure. Your surgeon will make an incision on your scrotum or the area above your pubic bone to access your testicl*s.
They will then clamp your spermatic cords to prevent bleeding before detaching your testicl*s and removing them. You may receive prosthetic testicl*s before your surgeon closes your wounds with stitches.
Learn more about what to expect from an orchiectomy.
Oral medications
If you receive oral medications such as relugolix, you’ll take these medications at home as prescribed.
Injected medications
Injections can be administered at a treatment center or your doctor’s office. Some people are taught to give their own injections. Your injection frequency depends on your medication.
For example, buserelin is injected three times a day for 1 week and then taken as a nasal spray.
Specific preparation may not be required if you’re taking hormone therapy medication. Before orchiectomy, you’ll likely need blood tests and other tests to make sure you’re in good enough overall health for surgery.
If you’re receiving general anesthesia, you’ll have to stop eating about 6 hours before your procedure and drinking about 2 hours before.
It can take up to a couple of weeks after an orchiectomy for your wounds to heal. You’ll need to avoid strenuous activity for about 6 weeks.
The cost of an orchiectomy can vary based on factors like your geographic location and your surgeon’s experience. For reference, the non-profit organization FAIR Health estimates that 80% of orchiectomy procedures in Logan, Utah cost less than $20,469, including hospital and anesthesia costs.
The cost of drug hormone therapies varies depending on your medication. In a 2023
If the treatment is deemed medically necessary, parts of it will likely be covered by insurance.
Other treatments for prostate cancer include:
- observation or active surveillance alone, where your cancer is monitored but no particular treatment is administered.
- surgery
- radiation therapy
- chemotherapy
- immunotherapy
- targeted drugs
- ablation therapies that use extreme heat or cold, such as:
- cryotherapy
- high intensity focused ultrasound
- photodynamic therapy
Here are some frequently asked questions people have about hormone therapy for prostate cancer.
What stage of prostate cancer requires hormone treatment?
Hormone therapy is used to treat
How long can someone stay on hormone therapy for prostate cancer?
You may have hormone therapy for anywhere between 4 months to about 3 years or more for people with metastatic prostate cancer. Orchiectomy is a one-time procedure.
Can hormone therapy cure prostate cancer?
Hormone therapy can help make other treatments more effective but doesn’t cure prostate cancer by itself.
What is life like after hormone therapy for prostate cancer?
Lowering androgens can cause changes to your body, such as problems sleeping, development of breast swelling, and loss of muscle. Your doctor can help you develop ways to reduce these symptoms.
Your cancer team can best advise you if you may benefit from hormonal therapy. They can also recommend which type of hormone therapy is best for you.
