• Prostate cancer cells require male hormone for development.
• Treatment to remove male hormone activity can control cancer growth wherever it is in the body.
• Hormone treatment is usually given by injection, but may also include tablets. It may last many years.
• Side effects of hormone treatment can include hot flushes, lack of interest in sex, tiredness and bone loss. Exercise can minimise these effects. It is important to keep up calcium intake and vitamin D levels.
• Drugs called bisphosphonates may help with bone loss.
• Hormone treatment can stop working after some years. Treatment then includes chemotherapy, new types of hormone treatment and new agents.

Hormone treatment controls cancer growth by reducing the effects of male hormones.

Introduction

Hormone treatment is the major treatment option for cancer that has spread beyond the prostate region or has recurred following initial treatment. It is also sometimes used with radiotherapy for the initial treatment of high risk prostate cancer. Here we describe what hormone treatment is, its effects and the long term outcome.

What is the male hormone and what does it do?

Male hormones (also called androgens) are important for the development and functioning of the male reproductive system. Men rely on normal levels of male hormones to have adult sexual function and fertility. The level of male hormone in the body is precisely controlled by several factors, the main one being the normal secretion of stimulatory hormones from the hypothalamus and the pituitary gland, two structures at the base of the brain. Testosterone is the principal male hormone. It is released from the testicles and is important for prostate growth. Both normal and cancerous prostate cells are stimulated to grow in the presence of male hormones.

What is hormone treatment?

Prostate cancer cells that have left the prostate and are growing in other areas of the body (metastases) are stimulated to grow by male hormones. A common treatment for metastatic prostate cancer is to lower the levels of male hormones in the body to control this growth. Prostate cancer cells typically die when the hormone levels are lowered. Unfortunately, not all prostate cancer cells die, and with time, often several years later, the cancer growth returns. Nevertheless, men receiving hormone treatment may get good cancer control and a symptom-free life for many years.

Hormone treatment is also called androgen ablation or androgen deprivation therapy.