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
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.
Hormone therapy is when doctors reduce the levels or potency of androgens to treat prostate cancer. According to the
- 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:
- surgical removal of the testicles called an orchiectomy
- luteinizing hormone-releasing hormone (LHRH) agonists, such as triptorelin and goserelin
- LHRH antagonists, such as degarelix and relugolix
- anti-androgens, such as flutamide and nilutamide
- abiraterone
- ketoconazole
- enzalutamide
- apalutamide
- darolutamide
Nonhormonal therapy is any prostate cancer therapy that does not work by affecting a person’s androgens.
Approved treatments
According to the
- surgery to remove all or part of the prostate called a prostatectomy
- radiation therapy
- chemotherapy
- targeted therapy
- immunotherapy
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
- 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
- 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
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
It is important to note that hormone therapy cannot cure prostate cancer alone.
It is also
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
- reduction in libido
- erectile dysfunction
- shrinkage of the testicles and penis
- shrinkage in muscles
- weight gain
- hot flashes
- breast tenderness, and breast growth
- osteoporosis
- increased cholesterol levels
- anemia
- cognitive impairment
- fatigue
- depression
- stomach issues
- diarrhea
- skin rashes
Nonhormonal therapy
Possible side effects from nonhormonal therapy
- Surgery can lead to erectile dysfunction, a hernia, and leakage from the bladder or rectum.
- Radiation therapy can lead to erectile dysfunction and urinary issues.
- Chemotherapy can cause nausea, weakness, and hair loss.
- Targeted therapy can cause fatigue, mouth sores, and high blood pressure.
- Immunotherapy can cause coughing, diarrhea, and headaches.
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.