Hormonal treatments, called androgen suppression therapy, reduce the amounts or potency of certain hormones to slow the development of prostate cancer. Nonhormonal treatments try to remove or kill prostate cancer cells.

Prostate cancer is when cells within the prostate begin to grow in an uncontrolled manner. This is the most common form of cancer in males and the sixth most common cause of cancer-related death.

This article discusses the difference between hormonal and nonhormonal treatments for prostate cancer.

After defining both approaches, this article looks at how each can treat prostate cancer. It also discusses the goals of treatment before comparing the administration, side effects, and efficacy of hormone and nonhormonal therapy.

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Hormone therapy is when doctors reduce the levels or potency of androgens to treat prostate cancer. According to the American Cancer Society (ACS), doctors can recommend this treatment under the following circumstances:

  • when surgery or radiation therapy is not appropriate
  • when surgery or radiation therapy does not cure the cancer
  • alongside radiation therapy for people with a higher risk of relapse
  • before radiation therapy to make this treatment more effective

The ACS notes that hormonal treatments may be helpful when someone is not a candidate for nonhormonal therapy. However, candidates for nonhormonal therapy can receive hormone treatment if appropriate.

Approved treatments

Hormonal treatments can include:

Nonhormonal therapy is any prostate cancer therapy that does not work by affecting a person’s androgens.

Approved treatments

According to the National Cancer Institute (NCI), several approved prostate cancer treatments exist. These include:

Hormone and nonhormonal therapy work in different ways.

Hormone therapy

Hormone therapies work by suppressing the effects of androgens within a person’s body. This is important, as these androgens make prostate cancer cells grow more quickly.

However, there are many different types of hormone therapy that work in the following ways:

  • reducing the number of androgens coming from the testicles
  • reducing the number of androgens coming from other body parts
  • preventing androgens from working properly

Nonhormonal therapy

Different nonhormonal therapies work in different ways. These include:

  • Surgery: There are different types of surgery to treat prostate cancer. A surgeon may perform a radical prostatectomy, which involves removing the prostate, the tubes that carry semen, and nearby lymph nodes.
  • Radiation therapy, chemotherapy, and immunotherapy: These kill cancer cells by using radiation, chemotherapy drugs, or the body’s immune response.
  • Targeted therapy: This works by attacking specific cancer-causing genetic mutations, which can kill cancer cells or reduce their growth.

Some people may receive multiple types of nonhormonal therapy.

Hormone and nonhormonal therapies can have different but complementary goals.

Hormone therapy

Hormone therapy aims to stop prostate cancer from growing too quickly. Hormone therapy can sometimes even cause prostate tumors to shrink in size.

Nonhormonal therapy

There are several possible goals of nonhormonal therapy.

These range from curing prostate cancer to limiting its growth and spread to other organs. Nonhormonal therapy can also sometimes address the symptoms of prostate cancer.

The efficacy of both forms of treatment is a topic of ongoing scientific interest.

Hormone therapy

The ACS notes that many issues surround the use of hormone therapy. There does not appear to be a consensus around when to start using it, when to stop using it, and the best way in which to administer it.

It is important to note that hormone therapy cannot cure prostate cancer alone.

It is also impossible to know how long the therapy will be effective. As a result, a person will need to undergo regular prostate-specific antigen (PSA) testing and intermittent imaging. PSA testing screens for prostate-specific antigens in the blood. These are proteins that the prostate gland produces.

Nonhormonal therapy

According to a 2017 systematic review and meta-analysis, nonhormonal therapies can increase the survival rate of people with prostate cancer.

Both forms of treatment can cause significant side effects.

Hormone therapy

There are many possible side effects of hormone therapy, which can vary with specific treatments:

Nonhormonal therapy

Possible side effects from nonhormonal therapy include:

The male hormone androgen can increase the rate at which prostate cancer grows. Hormone therapy targets this hormone to reduce prostate cancer growth rate.

Some hormone therapies work by stopping testicular androgen production with medications or surgically removing the testicles.

Other hormone therapies use medications to stop androgen production in other body parts. Contrastingly, some medications affect the potency of androgens rather than their production.

Hormone therapy cannot cure prostate cancer alone. Doctors can sometimes achieve this with nonhormonal options, such as surgery, radiation therapy, and chemotherapy. Targeted therapy and immunotherapy may also be helpful.