Hormonal therapy may be given to treat men with early (localised) prostate cancer:
- if they aren’t well or fit enough for surgery or radiotherapy
- if their cancer starts to progress while they are being monitored using watchful waiting
- if they are having radiotherapy.
It may be given before radiotherapy to help shrink the tumour. This is known as neo-adjuvant treatment. It may also be given during or after radiotherapy to reduce the chance of the cancer coming back. This is known as adjuvant treatment.
If you are having hormonal therapy, your specialist will tell you when you will have it and how long for.
Hormonal therapies can be given as injections or tablets.
Some drugs ‘switch off’ the production of male hormones from the testicles by reducing the levels of a hormone produced by the pituitary gland. They are known as leutenising hormone blockers and include:
Goserelin is given as a small pellet which is injected under the skin of the tummy (abdomen). Leuprorelin and triptorelin are given as liquids which are injected under the skin or into a muscle. The injections are given either monthly or every three months.
Other drugs work by attaching themselves to proteins (receptors) on the surface of the cancer cells. This blocks the testosterone from going into the cancer cells. These drugs are called anti-androgens.
Commonly used anti-androgens are:
- flutamide (Chimax®, Drogenil®) – this is taken three times a day
- bicalutamide (Casodex®) – this is taken once daily.
Anti-androgen tablets can be given alone. They may be given for one or two weeks before and after the first injection of a leutenising hormone blocker. This prevents tumour flare, which is when symptoms from the prostate cancer get worse after the first dose of treatment.