Hormone therapy

In the early 1940s two doctors, Huggins and Hodges, won the Nobel Prize for Medicine for their discovery that most prostate cancer cells are dependent on the male hormone testosterone for nourishment.

Combination hormone therapy (CHT) means the use of two drugs to control the bodies production of testosterone. It is the most widely used of several variations of hormone therapy. CHT combines the drugs to reduce or eliminate or block the effects of the production of testosterone from the testicles and adrenal glands.

Testosterone is produced primarily by the testes (testicles), and in much lesser amounts by the adrenal glands. A combination of drugs is used to (a) prevent production of testosterone by the testicles and (b) block the cancer tumor from using the testosterone can cause a substantial reduction in the total body tumor mass of cancer in about 80 per cent of cases.

This treatment is often used for patients whose prostate cancer has spread to other parts of the body or has come back after treatment. Most evidence shows that hormone therapy works better if it is started as early as possible after the cancer has reached an advanced stage. The goal of hormone therapy is to lower levels of the male hormones, androgens. 

Androgens are produced mainly in the testicles and cause prostate cancer cells to grow. Lowering androgen levels can make prostate cancers shrink or grow more slowly. But hormone therapy does not cure the cancer.

Until recently CHT was used primarily as a treatment of symptoms in late stage prostate cancer when it had spread outside the prostate capsule to surrounding tissue or the ones. However, evidence is accumulating that CHT may deserve a larger role in the management of prostate cancer.

CHT is increasingly being recommended for a few months prior to other procedures such as radical prostatectomy. Leading urologists, however, disagree on its use.

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