What is done?

  1. Medication. The main categories include:
    • Luteinizing hormone-releasing hormone (LHRH) agonists and LHRH antagonists are sometimes called medical castration or chemical castration. They are given as injections and stop the body from making androgens.
      • The first time you are given an LHRH agonist you may have a temporary spike testosterone levels called a “testosterone flare”. This flare can make clinical symptoms worse, especially if you have advanced prostate cancer and to help stop this you may be given another type of hormone therapy called anti-androgen therapy for the first few weeks of treatment.
      • LHRH antagonists such as do not cause testosterone flares.
    • Anti-androgens block the effects of androgens on prostate cancer and prostate-related cells by blocking the androgen receptor. These are oral pills.
    • Estrogens or female hormones. Estrogens are rarely used because they have potentially serious side effects but they can also help reduce the amount of androgens. They are usually given as pills.  
    • Abiraterone and enzalutamide. These are new types of hormone therapy for men with advanced prostate cancer that has spread around the body. It may be given in combination with ADT or after ADT has stopped working.

  2. Surgical removal of one or both of the testicles (orchiectomy) prevents testosterone production.  Another name for this approach is “surgical castration”.  It is rarely used because the effects are irreversible.

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