Androgen Deprivation Therapy

Also known as: Androgen Suppression Therapy, Hormone Therapy

At Providence, your cancer diagnosis is met with personalized, compassionate care and innovative, strategic treatment. Depending on the nature of your cancer, your doctors may recommend androgen deprivation therapy, also known as androgen suppression therapy.

Androgen deprivation therapy is a type of hormone therapy used to combat prostate cancer. Its goal is to keep prostate cancer cells from receiving the male hormones (androgens) they need in order to grow.

The main androgens in the body are testosterone and dihydrotestosterone (DHT). The main sources of the male hormones (androgens) are the testicles, but the adrenal glands also produce small amounts.

Androgen deprivation therapy uses drugs, surgery, or a combination of both.

Drug therapy

Your doctor may suggest a drug that can block natural hormones. Examples of these drugs include:

  • Luteinizing hormone-releasing hormone (LHRH) agonists: drugs that can prevent the testicles from making testosterone. Examples are leuprolide and goserelin.
  • Anti-androgens: drugs that can block the action of male hormones. Examples are flutamide and bicalutamide.
  • Other androgen-suppressing drugs: these can prevent the adrenal gland from making testosterone. Examples are ketoconazole and abiraterone.

Surgery

Surgery can also be used to reduce hormone levels by removing the testicles. This procedure is called an orchiectomy.

Combined Androgen Blockade (CAB)

After orchiectomy or treatment with an LHRH agonist, your body no longer gets testosterone from the testicles. However, the adrenal gland still produces a small amount of male hormones. You may receive an antiandrogen to block the action of the male hormones that remain. This combination of treatments is known as total androgen blockade. Studies have not shown whether total androgen blockade is more effective than surgery or an LHRH agonist alone.

Doctors can usually control prostate cancer that has spread to other parts of the body with hormone therapy. The cancer often does not grow for several years. But in time, most prostate cancers can grow with very little or no male hormones. Hormone therapy is no longer helpful. At that time, your doctor may suggest other forms of treatment.

Castrate-resistant prostate cancer (mCRPC) means that the androgen deprivation therapy (ADT) measures stop adequately controlling the cancer. At this point some patients will go on to further forms of treatment.

Advanced forms of treatment include:

  • Enzalutamide: an oral drug that further blocks the effects of testosterone on the cancer throughout the body.
  • Abiraterone: an oral drug that further prevents even small amounts of testosterone from being produced within the body.
  • Chemotherapy: drug agents have been shown to be effective against prostate cancer and their toxicities have improved immensely over the last decades.
  • Vaccine treatment:
    • Sipuleucel –T (Provenge) is a vaccine approach where your blood is removed, exposed to prostate cancer identifiers and then placed back into your body to boost your immune response to cancer.
    • Xofigo (radium Rz 223 dichloride): an injection used to treat prostate cancer that is resistant to medical or surgical treatment that lowers testosterone (castrate-resistant prostate cancer) and has spread to your bones with symptoms, but not to other parts of your body. It delivers a brief but strong energy to the cancer to lessen symptoms and prolong survival. Find more information at xofigo-us.com