What is it?

Hormone treatment is “androgen deprivation”. That means it reduces the testosterone in a man’s body to very low levels. This has a profound effect on prostate cancer since the vast majority of prostate cancer tissue relies on testosterone to grow.

Originally the only treatment available was to remove the part of the testes that produces testosterone (a bilateral sub-capsular orchidectomy). This is still preferred by some people but leads to permanent removal of testosterone. In men with early disease this is obviously not appropriate.

Other methods have been developed to block the hormone effect on a temporary basis, rather than permanently, using medication rather than surgery. These treatments may be recommended for between six months and two years for men with localised disease. For men where the cancer has spread to other parts of the body, permanent treatment is preferred although we are studying whether it is safe to use the drugs intermittently.

One of the most common drugs is given as an injection or an implant either monthly or three-monthly. It stops the testes from producing testosterone, reducing levels in the bloodstream by over 90%.

Tablets may be offered in addition, to block the hormone coming from the adrenal glands. These work either by stopping the gland from making the hormone, or by preventing cells elsewhere in the body absorbing it. We often recommend a short course of the tablets to cover the first few weeks while the implant is taking effect.

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