About this page. This is a plain English summary of hormone therapy for prostate cancer. It does not replace medical advice from your own doctor or specialist.
For full information and references, please read the detailed page.
Why are hormones used to treat prostate cancer?
Most prostate cancer cells need the male hormone testosterone to grow. If the supply of testosterone is reduced or blocked, the cancer cells slow down and many of them die.
Hormone therapy does not "cure" prostate cancer in the way that surgery or radiotherapy might in early disease, but it is very effective at slowing the cancer down. It is mostly used in two situations:
- Together with radiotherapy, when a cancer is more aggressive.
- For cancer that has spread, or in older men where the priority is controlling the cancer rather than removing it.
The two main types
- LHRH agonists tell the brain to stop signalling the testes to make testosterone, so the testosterone level in the blood drops. They are given as injections - either monthly, three-monthly, or six-monthly - usually under the skin of the abdomen or into a muscle. The effect is similar to surgically removing the testes, but it is reversible.
- Anti-androgens work at the cancer cell itself, blocking the place where testosterone normally attaches. They are taken as tablets.
Large studies (including a major Lancet study cited on the detailed page) found that LHRH agonists on their own work about as well as combined therapy, so most men today are treated with LHRH agonist injections alone.
Continuous or "pulse" hormone therapy?
One advantage of injection therapy is that it can be given as a "pulse" - on for a while, then stopped, then restarted if the PSA starts to rise again. This is called intermittent hormone therapy. Studies suggest it works about as well as continuous hormone therapy for many men, with a better quality of life because of fewer side effects.
Common side effects
- Hot flushes.
- Tiredness or low energy.
- Erection problems.
- Some breast tenderness or breast enlargement.
- Mood changes.
- Over the longer term, thinning of the bones and changes to body composition (more fat, less muscle).
Many of these can be managed with the help of your GP, exercise, and sometimes additional medicines (for example to protect the bones).
Important things to know
- Hormone therapy lowers testosterone, so it almost always causes some change to sex drive and erections. This is real and worth talking through honestly with your specialist and your partner.
- Long-term hormone therapy can thin the bones over time, which can increase the risk of fractures. Bone protection is part of good follow-up.
- Hot flushes are very common but can usually be managed.
- Hormone therapy is rarely used as the only treatment for early, localised prostate cancer. It is most useful alongside other treatments, or when cancer has spread.
- The treatment is usually given by a GP at your local clinic, which most men find more convenient than travelling to a specialist for every dose.
What you can do next
- Read the full detailed page with references.
- Short version: radiotherapy, which is often combined with hormone therapy.
- Short version: the full menu of treatment options.
- Short version: dealing with a new diagnosis.
- Request a second opinion on a treatment plan.
- Call 02 8382 6980 to make an appointment.