Why Hormone Therapy Isn't Enough

In almost every man with advanced disease, hormone therapy prolongs life and eases many symptoms, often bringing a dramatic improvement to quality of life. Sometimes, the cancer can be kept at bay for many years.

When a man starts hormone therapy, the early results are successful: The tumor shrinks, PSA levels drop, and -- most importantly -- the patient feels better. But then, slowly, inevitably, the cancer makes a comeback, and PSA levels, which had fallen so encouragingly before, begin to creep back up.

Why doesn't the effect of hormones last forever? The problem is that prostate cancer is "heterogenous" -- it's made up of many different kinds of cells. Some of them respond brilliantly to hormones; these cells aren't the problem. It's the other kind -- the cells that are hormone-resistant, that continue unfazed despite this treatment -- that ultimately cause hormone therapy to fail. And this is why chemotherapy is needed: To target and kill these ruthless cells.