Harvard Perspectives on Prostate Disease

Intermittent hormone therapy for prostate cancer

Editor in Chief Marc B. Garnick, M.D., discusses this therapy, which aims to strike a balance between effective treatment and quality of life

Androgens, the family of male sex hormones that includes testosterone, trigger sexual development, the growth of facial hair, a deepening voice, and increased muscle and bone mass. But when prostate cancer begins to develop, androgens seemingly turn traitor by fueling tumor growth. In the 1940s, Dr. Charles Huggins, a researcher at the University of Chicago, demonstrated in Nobel Prize""winning experiments that shutting down androgen production could rein in prostate cancer. Since then, androgen deprivation, commonly called hormone therapy, has been the mainstay of treatment for metastatic prostate cancer.

Given that the testicles pump out 90% to 95% of androgens (the adrenal glands churn out the balance), early therapies involved surgical removal of the testicles or the administration of a female hormone called diethylstilbestrol (DES) to block androgen production. Today, physicians generally prescribe drugs, such as a luteinizing hormone""releasing hormone (LHRH) agonist, to achieve the same benefit without the cardiovascular side effects that accompany DES or the psychological impact of castration.

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