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Medications for Prostate Cancer -- Hormonal Therapy

The information provided here is meant to give you a general idea about each of the medications 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 medications 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. Hormonal therapies are the main prescription drugs used to treat prostate cancer. For cancer that has spread to the bones, other medications may be prescribed.

Hormonal Therapies

Luteinizing Hormone-releasing Hormone (LHRH) Analogs

  • Leuprolide
  • Goserelin

Anti-androgens

  • Flutamide
  • Bicalutamide
  • Nilutamide
  • Enzalutamide

Androgen Suppressants

  • Ketoconazole

CYP17A1 Inhibitors

  • Abiraterone

Bisphosphonates

  • Zoledronic acid
  • Pamidronate
  • Alendronate
  • Risedronate
  • Ibandronate

Denosumab

Hormonal Therapies

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 testicles (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
  • Goserelin

These medications decrease the production of the male hormone, testosterone, from the testicles. These medications are given by injection into a muscle every few months.

Possible side effects include:

Anti-androgens

Common names include:

  • Flutamide
  • Bicalutamide
  • Nilutamide

Anti-androgens prevent your body from using androgens. Possible side effects include:

  • Nausea and vomiting
  • Diarrhea
  • Breast growth or tenderness—gynecomastia
  • Change in sexual ability or desire
Androgen Suppressants

Common name: ketoconazole

Ketoconazole blocks the production of androgens. It is considered a second-line hormonal treatment. It may be used when other medications are not working.

Possible side effects include:

  • Nausea and vomiting
  • Liver problems
  • Itchy skin
CYP17A1 Inhibitors

Common names include:

  • Abiraterone

Abiraterone works by blocking an enzyme that is needed to make testosterone. The drug affects the ability of the testicles and body tissue from making this male hormone.

Possible side effects include:

Bisphosphonates

  • Zoledronic acid (given through an IV)
  • Pamidronate
  • Alendronate
  • Risedronate
  • Ibandronate

Prostate cancer usually spreads to the bones. This can cause pain, weakened bones, and an increased risk of bone fractures. Bisphosphonates are used to slow bone loss, increase bone density, and decrease the risk of fractures. Most of these medications can be taken by mouth.

Possible side effects include:

Denosumab

Denosumab is a medication that is used to boost the body's immune system. It blocks the development of cells that break down bone tissue. It is given as an injection every 4 weeks.

Possible side effects include:

  • Joint and muscle pain
  • Low calcium levels in the blood—hypocalcemia
  • Flu-like symptoms
  • Headache
  • Nausea or vomiting
  • Jaw bone damage
  • Increased risk of an unusual thigh bone fracture

Special Considerations

If you are taking medications, follow these general guidelines:

  • Take the medication as directed. Do not change the amount or the schedule.
  • Ask what side effects could occur. Report them to your doctor.
  • Talk to your doctor before you stop taking any prescription medication.
  • Do not share your prescription medication.
  • Medications can be dangerous when mixed. Talk to your doctor or pharmacist if you are taking more than one medication, including over-the-counter products and supplements.
  • Plan ahead for refills as needed.

Revision Information

  • Denosumab. EBSCO DynaMed Plus website. Available at: https://www.dynamed.com/topics/dmp~AN~T900410/Denosumab. Updated April 11, 2017. Accessed April 20, 2017.

  • Management of bone metastases of prostate cancer. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T905989/Management-of-bone-metastases-of-prostate-cancer. Updated February 5, 2017. Accessed April 20, 2017.

  • Preventing and treating prostate cancer spread to bones. American Cancer Society website. Available at: https://www.cancer.org/cancer/prostate-cancer/treating/treating-pain.html. Updated March 11, 2016. Accessed April 20, 2017.

  • Prostate cancer. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/genitourinary-disorders/genitourinary-cancer/prostate-cancer. Updated November 2013. Accessed April 20, 2017.

  • Treatment option overview. National Cancer Institute website. Available at: https://www.cancer.gov/types/prostate/patient/prostate-treatment-pdq. Updated July 7, 2016. Accessed April 20, 2017.