Prostate cancer cells need male hormones, called androgens, to grow. Testosterone is an androgen that is made by the testicles. Blocking these hormones with androgen deprivation therapy (ADT), also called or hormone therapy, can slow tumor growth or shrink the tumor. Blocking these hormones is accomplished in various ways:
- Preventing the testes from making testosterone. The primary source of testosterone in the body is the testes which produce testosterone. Drugs called luteinizing hormone-releasing hormone (LHRH) agonists, are given to prevent the testes from making testosterone. Although this treatment has significant side effects and almost always loses its effectiveness over time, ADT is still a very effective whole-body therapy. However, it should not be given routinely for those with early-stage, low-risk prostate cancer.
- Blocking androgen receptors. Over the last decade, it has become evident that both the primary cancer (within the prostate) as well as metastatic sites (lymph nodes and bone) can also make testosterone and feed the cancer, without ever leaking out into the circulation. Drugs called androgen receptor (AR) targeted therapy can be used to block testosterone from sources other than the testes. These include oral drugs like abiraterone (Zytiga), or enzalutamide (Xtandi), apalutamide (Erleada) or darolutamide (Nubeqa).
Medical management of prostate cancer often begins with LHRH therapy and AR targeted therapy, either at the same time or sequentially.
Support for men on hormone therapy
Roswell Park sponsors a prostate cancer education group for patients who are being treated with hormone therapy. Each meeting features an expert discussing the latest treatment advances, diet, exercise, dealing with sexual side effects, integrative medicine options, ways to manage symptoms and other topics. The group meets once a month at Roswell Park. For more information, call 716-845-8665.