Medications for Prostate Cancer—Hormonal Therapy

The information provided here is meant to give you a general idea about each of the medicines listed below. Only the most general side effects are included, so ask your doctor if you need to take any special precautions. Use each of these medicines as recommended by your doctor, or according to the instructions provided. If you have further questions about usage or side effects, contact your doctor.
The type of treatment you will have will depend on the stage of the cancer, the size of the tumor, your age, and overall condition. The main prescription drug therapies used to treat prostate cancer are hormonal therapies.

Hormonal Therapy

Prostate cells need male hormones, called androgens, to grow and work properly. The aim of hormonal therapy is to reduce the amount of male hormones in your body so that prostate cells are not stimulated to grow. The most effective hormonal therapy is to undergo surgery to remove the testes (called orchiectomy). This is effective surgery, but it is irreversible. Often hormonal therapies are combined to achieve greater effects.
Different types of hormonal therapies include:
Luteinizing Hormone-releasing Hormone (LHRH) Analogs
Common names include:
  • Leuprolide (Lupron)
  • Goserelin (Zoladex)
These medicines decrease the production of the male hormone, testosterone, from your testicles. These medicines are given by injection into a muscle every few months.
Possible side effects include:
  • Impotence
  • Hot flashes
  • Loss of sexual desire
  • Osteoporosis
  • Fatigue
  • Increased risk of heart disease and diabetes
Anti-androgens
Common names include:
  • Flutamide (Eulexin)
  • Bicalutamide (Casodex)
  • Nilutamide (Nilandron)
Anti-androgens prevent your body from using androgens. Possible side effects include:
  • Nausea and vomiting
  • Diarrhea
  • Breast growth or tenderness
  • Change in sexual ability or desire
Androgen Suppressants
Common name: ketoconazole (Nizoral)
Ketoconazole blocks the production of androgens. It is considered a second-line hormonal treatment. It may be used when other medicines are not working.
Possible side effects include:
  • Nausea and vomiting
  • Liver problems
  • Itchy skin

Newer Hormonal Therapies

Abiraterone
Common name: abiraterone (Zytiga)
Abiraterone works by blocking an enzyme that is needed to make testosterone. The drug affects the ability of the testes and body tissue from making this male hormone.
Possible side effects include:
Enzalutamide (Xtandi)
Common name: enzalutamide (Xtandi)
This medicine has been approved by the Food and Drug Administration (FDA) for men that have late-stage prostate cancer that has not responded to other treatments. Enzalutamide, a type of anti-antigen, prevents your body from using androgens.
Possible side effects include:
  • Weakness
  • Back pain
  • Diarrhea
  • Joint pain

Special Considerations

If you are taking medicines, follow these general guidelines:
  • Take your medicine as directed. Do not change the amount or the schedule.
  • Do not stop taking them without talking to your doctor.
  • Do not share them.
  • Know what the results and side effects. Report them to your doctor.
  • Some drugs can be dangerous when mixed. Talk to a doctor or pharmacist if you are taking more than one drug. This includes over-the-counter medicine and herb or dietary supplements.
  • Plan ahead for refills so you don’t run out.

References

Abiraterone for prostate cancer. Cancer Research UK website. Available at: http://cancerhelp.cancerresearchuk.org/about-cancer/cancer-questions/abiraterone-for-prostate-cancer. Accessed September 20, 2012.

Abiraterone (Zytiga). Cancer Research UK website. Available at: http://cancerhelp.cancerresearchuk.org/about-cancer/treatment/cancer-drugs/abiraterone#common. Accessed September 20, 2012.

Angiogenesis inhibitors. National Cancer Institute website. Available at: http://www.cancer.gov/cancertopics/factsheet/Therapy/angiogenesis-inhibitors. Accessed September 19, 2012.

Detailed guide: prostate cancer. American Cancer Society website. Available at: http://www.cancer.org/ . Accessed October 9, 2008.

Evolution of cancer treatments: targeted therapy. American Cancer Society website. Available at: http://www.cancer.org/Cancer/CancerBasics/TheHistoryofCancer/the-history-of-cancer-cancer-treatment-targeted-therapy. Updated June 8, 2012. Accessed September 19, 2012.

Hormone (androgen deprivation) therapy for prostate cancer. American Cancer Society website. Available at: http://www.cancer.org/Cancer/ProstateCancer/DetailedGuide/prostate-cancer-treating-hormone-therapy. Updated September 4, 1012. Accessed September 19, 2012.

Hormone therapy for prostate cancer. Mayo Clinic website. Available at: http://www.mayoclinic.com/health/hormone-therapy-for-prostate-cancer/MY01633. Updated August 10, 2012. Accessed September 19, 2012.

Prostate cancer. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated August 20, 2012. Accessed September 19, 2012.

Prostate cancer. National Cancer Institute website. Available at: http://www.cancer.gov/cancertopics/types/prostate . Accessed October 9, 2008.

Study: new drug enzalutamide extends life in advanced prostate cancer. American Cancer Society website. Available at: http://www.cancer.org/Cancer/news/study-new-drug-enzalutamide-extends-life-in-advanced-prostate-cancer. Accessed September 20, 2012.

Targeted therapy for prostate cancer. Texas Oncology website. Available at: http://www.texasoncology.com/types-of-cancer/prostate-cancer/targeted-therapy-for-prostate-cancer/. Accessed July 31, 2012.

Xtandi (Enzalutamide) approved for late stage prostate cancer, FDA. Medical News Today website. Available at: http://www.medicalnewstoday.com/articles/249785.php. Accessed September 19, 2012.

2/12/2010 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Smith DP, King MT, Egger S, et al. Quality of life three years after diagnosis of localised prostate cancer: population based cohort study. BMJ. 2009;339:b4817.

10/25/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php: US Food and Drug Administration. Include warnings on risk for class of prostate cancer drugs US Food and Drug Administration website. Available at: http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm230334.htm . Published October 20, 2010. Accessed October 25, 2010.

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