Hormonal therapy is usually given with radiotherapy to locally advanced prostate cancer, but it may be given on its own.
It may be given before radiotherapy to help shrink the tumour. This is known as neo-adjuvant treatment.
It may be given during or after radiotherapy to reduce the chance of the cancer coming back. This is known as adjuvant treatment.
Hormonal therapies can be given as injections or tablets.
Some drugs ‘switch off’ the production of male hormones by the testicles by reducing the levels of a hormone produced by the pituitary gland. They are known as leutenising hormone blockers or LHRH agonists. These include:
Goserelin is 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. 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:
- bicalutamide (Casodex®) – this is taken once daily
- flutamide (Chimax®, Drogenil®) – this is taken three times a day
- cyproterone acetate (Cyprostat®) – this is taken two or three times daily.
Anti-androgen tablets are usually 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.