When is hormone treatment used for prostate cancer?

A minority of patients with initially localized prostate cancer will have their disease return in distant sites in the body following local treatment with radical prostatectomy (surgery to remove the prostate), brachytherapy (radiation delivered over a short distance), or definitive intensity modulated radiation therapy (IMRT; higher doses of radiation to target tissues, while minimizing the dose delivered to normal organs). Other patients may have cancer that's already metastasized (spread) to distant sites at the time of their diagnosis. For these groups of patients, the primary method of treatment is "hormone therapy."

Of the two main types of medications, luteinizing hormone releasing hormone (LHRH) agonists have the most potent effects on decreasing testosterone rapidly. However, urologists will often also add oral anti-androgen pills to LHRH agonists for total androgen blockade (TAB). Depending upon the aggressiveness of the cancer cells, these medications can kill a large proportion of cancer cells and prevent the disease from progressing for an average of one to three years. Unfortunately, these treatments for patients with metastatic prostate cancer aren't curative.