November 1, 2014

   A Publication of the James Buchanan Brady
   Urological Institute Johns Hopkins Medical Institutions

Volume IV, Spring 1997

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.

 

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