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Hormone Therapy for Stage IV Prostate Cancer

Prostate cancer refers to cancer that originates in the male prostate gland. Most prostate cancers are hormone receptive, which means the cancer depends on male hormones to grow. As a result, hormone therapy can be useful in treating Stage IV cancer. This refers to prostate cancer that has metastasized (spread) to other parts of the body.

  1. When is Hormone Therapy Used?

    • Hormone therapy is not a cure for Stage IV cancer, because there are no cures for Stage IV cancer. Once it has metastasized it can't be removed. Instead, hormone therapy is used to slow its growth. This may help to prolong life and/or stop or lessen the symptoms associated with metastatic prostate cancer. Hormone therapy is used in most patients in Stage IV, along with other treatments including radiation and surgery.

    Types of Hormone Therapy

    • The most effective method of hormone therapy is to surgically remove the testicles. This procedure, called orchiectomy, is effective since 90 percent of male hormones (androgens including testosterone) are made in the testicles. Although this is an outpatient procedure, there are some side effects including hot flashes, breast tenderness or breast growth, osteoporosis and depression. Luteinizing hormone-releasing hormone (LHRH) is a form of drug therapy that suppresses testosterone production in the body. Patients who chose LHRH have to visit the doctor frequently for injections. A third option, anti-androgen drugs like flutamide, bicalutamide and nilutamide are taken in pill form and block the body's ability to use androgens.

    Is Hormone Therapy Always Used?

    • Some prostate cancers don't respond to hormone therapy. Others respond initially, but the treatment loses its effectiveness over time. Stage IV prostate cancer that does not respond to hormone therapy is called Hormone-refractory prostate cancer (HRPC). This form is more difficult to treat. Biotherapy drugs--which encourage the body's natural immunity to fight the cancer--is usually the best option, along with specific treatments designed to manage the areas of metastases. For example, bisophosphates are a form of biotherapy given to men with prostate cancer that has metastasized in the bones in order to help prevent bone loss and fragmentation.

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