When should Androgen Deprivation Therapy be used?

(A) Androgen suppression refers to treatment where male hormone production by the body is reduced using drugs. Luteinizing hormone-releasing hormone (LHRH) is a hormone that reduces production of a male hormone testosterone. Suppression of these hormones prevent growth of cancer cells. Androgen suppression therapy should be continued with substances that increase or decrease LHRH activity unless both testicles were removed previously.

(B) Anti-androgens are drugs that prevent androgens from working, thus preventing the growth of prostate cancer cells. Patients whose conditions deteriorate on LHRH treatment or removal of testicles should be started on an anti-androgen drug such as bicalutamide. Following further deterioration, the anti-androgen should be withdrawn.

(C) Alternative anti-androgen drugs may be considered but there may be limited decrease in prostate specific antigen (PSA) following disease deterioration. An increased level of PSA correlates with presence of prostate cancer cells.