Prostate Cancer and Hormone Therapy

Dear GBS00734c05a 

Thank you for getting in touch with Macmillan Cancer Support and the Online Community. My name is Gillian, and I’m one of the Cancer Information Nurse Specialists on the Macmillan Support Line.

I’m very sorry to hear about your prostate cancer diagnosis earlier this year. I hope you’re recovering well following your radiotherapy treatment. It’s encouraging to hear that your PSA level is now undetectable, that’s a very positive outcome.

I understand you may have concerns about the ongoing hormone therapy as part of your treatment plan. You’re absolutely right that hormone therapies such as Abiraterone and Decapeptyl  work by suppressing the growth of prostate cancer cells rather than directly killing them. These treatments are commonly recommended following radiotherapy, which targets and destroys cancer cells by damaging their DNA.

For patients with high-risk prostate cancer such as those with a  Gleason score of 8–10, long-term hormone therapy (typically 2–3 years) is advised. The goal is to deprive any remaining microscopic cancer cells of testosterone, which they rely on to grow, thereby reducing the risk of recurrence and spread.

Several clinical studies and NICE guidelines support this approach, showing that extended hormone therapy after radiotherapy can significantly lower the risk of metastasis (Secondary cancers) and improve overall survival outcomes.

If you have any concerns or questions about your treatment plan, I would encourage you to speak with your Clinical Nurse Specialist (CNS) or consultant. They’ll be able to provide more personalised guidance and reassurance.

I hope this information has been helpful. Please don’t hesitate to contact our nursing team directly if you’d like to talk through your concerns or need further support.

Warmest wishes,
Gillian Greenway
Cancer Information Nurse Specialist
Ref:AON

Gillian,

Thanks for your reply.  what I am having difficulty is the fact that the hormone therapy deprives those concer cells from testosterone which they require TO GROW.  i.e. it doesn't kill them so why don't they grow after the hormone therapy stops.  Or do they naturally have a lifespan?

Hello GBS00734c05a,

Thanks for getting back in touch.

My name is Carole and I’m one of Gillian’s colleagues the Macmillan Support Line.

It’s only natural to want to understand why a particular treatment is given for a specific amount of time.

As Gillian explained, radiotherapy damages cell DNA which stops them growing. However, radiation therapy doesn’t kill cells right away.

The National Cancer Institute states that ‘it takes days or weeks before DNA is damaged enough for cancer cells to die. Then, cancer cells keep dying for weeks or even months, after radiation ends’.

Lots of studies have looked at the role of adjuvant (after radiotherapy) hormone therapy. When this is given after radiotherapy, the aim of treatment, is to stop the cancer from coming back.

It’s difficult to find information about precisely how this happens, and I can understand how frustrating this may be.

It might be worth getting in touch with your hospital specialist team as they may be able to discuss this in more detail with you.

I hope this is helpful, and please don’t hesitate to get back in touch if you have further questions. You are welcome to give us a call if you would like to speak to a nurse, or you can chat to us online if you prefer.

Best wishes,

Carole

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