Hormone therapy

drugs such as Zoladex, Casodex

Hormone therapy has been used for more than 70 years as a treatment for advanced prostate cancer, both to slow the growth of the cancer and to reduce symptoms such as bone pain. It works by depriving prostate cancer cells of the male hormone testosterone on which they depend to grow and spread. While this can also be achieved by surgery (removal of the testicles), hormones are a more common choice these days. They are taken over a period of months or years, either by injection or in tablet form, and their use is normally supervised by one of our oncologists.

Who is it suitable for?

Men with either advanced or locally advanced prostate cancer, ie those whose tumour has spread beyond the prostate gland and which is therefore not treatable by surgery; also for those with cancer that has recurred after initial treatment. It is also commonly used to help shrink the prostate prior to radiotherapy.

How does it work?

The male hormone, testosterone, is produced in the testicles and stimulates prostate cancer growth. Hormone therapy works by blocking the effect of the testosterone, reducing the size of the tumour and delaying its growth and tendency to spread.

There are two main types of hormone therapy:

LHRH analogues (Zoladex, Prostap) mimic a naturally occurring hormone and work by switching off production of testosterone. They are given by injecting an implant at monthly or three-monthly intervals into the abdominal fat. Men receiving the LHRH analogue will lose their sex drive and are unable to achieve an erection; they may also have hot flushes, breast swelling, fatigue and weight gain.

Anti-androgens (Casodex) block the action of testosterone on cancer cells and are given as a tablet. Anti-androgens can also be used on their own to help slow the progress of advanced prostate cancer when it has not spread to the bones. They have less effect on sex drive and function and are less likely to cause bone and muscle weakness than LHRH analogues; but they may cause more breast swelling and tenderness which some patients find troublesome.

Where is it done?

Your treatment can be discussed, prescribed and followed up at The Prostate Centre.

How much does it cost?

These drugs may be available from your GP surgery; some private health schemes cover their cost but not all do. On private prescription you can expect to pay approximately £300-400 per month for Casosdex and around the same sum for a three-month depot injection of Zoladex.