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.