Hormone therapy is a common treatment for prostate cancer in the UK, particularly when the cancer depends on male hormones (especially testosterone) to grow. It is also called androgen deprivation therapy (ADT).

How hormone therapy works

Most prostate cancer cells are stimulated by testosterone. Hormone therapy reduces testosterone levels or blocks its effect, which can:

• slow or stop prostate cancer growth
• shrink the cancer before other treatments (such as radiotherapy)
• improve the effectiveness of radiotherapy
• control cancer that has spread (advanced or metastatic prostate cancer)

Types of hormone therapy used in the UK

1. LHRH agonists (injections or implants)
These lower testosterone production by the testicles. Common examples include:

• Zoladex (goserelin)
• Prostap (leuprorelin)
• Decapeptyl (triptorelin)

They are usually given every 1, 3, or 6 months depending on the product.

2. LHRH antagonists
These reduce testosterone more quickly and may be used in certain situations:

• Firmagon (degarelix)

3. Androgen receptor blockers and newer hormone medicines
These block testosterone signals or reduce hormone production elsewhere in the body. Examples include:

• Bicalutamide
• Abiraterone acetate (usually combined with a steroid such as prednisolone)
• Enzalutamide
• Apalutamide
• Darolutamide

When hormone therapy is used

Doctors may recommend it for:

• High-risk or locally advanced prostate cancer — often alongside radiotherapy, sometimes for several years
• Cancer that has spread (metastatic prostate cancer) — usually as long-term treatment
• Recurrence after surgery or radiotherapy — to control rising PSA levels
• Some men who cannot have surgery or radiotherapy

Common side effects

Because hormone therapy lowers testosterone, side effects can include:

• hot flushes and sweating
• reduced sex drive and erectile difficulties
• tiredness
• mood changes
• weight gain and increased body fat
• loss of muscle strength
• reduced bone density (osteoporosis risk)
• changes in cholesterol and blood sugar
• increased risk of cardiovascular problems in some men

Your oncology team may monitor:

• PSA levels
• testosterone levels
• bone health
• blood pressure, cholesterol and diabetes risk

How long is treatment?

It depends on the situation:

• With radiotherapy: often 6 months to 3 years for higher-risk disease
• Advanced/metastatic disease: often continued long-term, unless the cancer stops responding or treatment is changed

Access in the UK

Treatment decisions are usually made by a specialist urology or oncology team based on factors such as:

• PSA level
• Gleason score / Grade Group
• stage of cancer
• scan results
• overall health and preferences

For UK patient information, the following organisations provide reliable guidance:

• Prostate Cancer UK
• NHS prostate cancer treatment information