Hormone Therapy for Prostate Cancer

In people with early-stage prostate cancer, hormone therapy may help shrink tumors before and during radiation therapy. Hormone therapy can slow the growth of any cancer cells left behind after surgery or radiation therapy. In people with advanced or metastatic prostate cancer, hormone therapy can be used to shrink the cancer and slow the growth of tumors. It can also treat cancer that comes back after treatment. 

There are many types of hormone therapies, including shots and pills. 

These are the hormone therapy drugs that are used most often to treat prostate cancer. New treatments become available all the time, so this may not be a complete list.  

Please note: The side effects listed here do not represent a comprehensive list. Each hormone therapy drug has its own set of side effects and ways of working. It's important to discuss all potential side effects of a drug with your healthcare team. Be sure to tell your healthcare team about any side effects you do have.  

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All Available Treatments

IV (through a vein) =      Pill =

Treatment Type

Luteinizing hormone-releasing hormone (LHRH) agonists (analogs)

Drug Names
(Leuprolide acetate) Lupron Depot®, Eligard® (IV)
(Leuprolide mesylate) Camcevi® (IV)
(Triptorelin) Trelstar® (IV)
(Goserelin) Zoladex® (IV)
Potential Side Effects
Fatigue/weakness Hot flashes Fertility issues Penis/scrotum shrinkage Weight/appetite changes Joint pain/stiffness Bone Thinning Breast tissue tenderness or enlargement Emotional or cognitive changes Low blood counts
Important Things to Know
  • These drugs stop the testicles from producing testosterone. They may cause an initial 
    temporary rise, or “flare,” in testosterone before shutting it down.
  • Long-term therapy can cause bone loss; your doctor may check your bone health.
  • Low blood counts may put you at risk for anemia, infection, or bleeding.
  • Stroke is rare, but your doctor will monitor your risk. 

Treatment Type

LHRH antagonists

Drug Names
(Degarelix) Firmagon® (Pill) (IV)
(Relugolix) Orgovyx® (Pill) (IV)
Potential Side Effects
Fatigue/weakness Hot flashes Fertility issues Penis/scrotum shrinkage Weight/appetite changes Joint pain/stiffness Bone Thinning Breast tissue tenderness or enlargement Emotional or cognitive changes Low blood counts
Important Things to Know
  •  These drugs bind and block receptors that help the testicles produce testosterone.
  • Hormone therapy may increase the risk of certain chronic diseases (e.g., high blood 
    pressure, diabetes, heart disease) in some men.
  • Long-term therapy can cause bone loss; your doctor may check your bone health.
  • Low blood counts may put you at risk for anemia, infection, or bleeding.
  • Stroke is rare, but your doctor will monitor your risk. 

Treatment Type

Androgen biosynthesis inhibitor

Drug Name
(Abiraterone acetate) Zytiga®, Yonsa® (Pill)
Potential Side Effects
Joint pain/stiffness Fatigue/weakness Blood pressure changes Hot flashes Swelling Nausea/vomiting Diarrhea
Important Things to Know
  • These drugs block androgens (male hormones) from forming in cells throughout the body, 
    outside of the testicles.
  • These drugs are typically used for advanced prostate cancer that is high risk or castration
    resistant (still growing despite low testosterone levels).
  • These drugs are taken with prednisone (a steroid) to help reduce side effects. 

Treatment Type

Anti-androgens (androgen receptor antagonists)

Drug Names
(Apalutamide) Erleada® (Pill)
(Bicalutamide) Casodex® (Pill)
(Darolutamide) Nubeqa® (Pill)
(Enzalutamide) Xtandi® (Pill)
(Flutamide) Eulexin® (Pill)
(Nilutamide) Nilandron® (Pill)
Potential Side Effects
Fatigue/weakness Hot flashes Weight/appetite changes Diarrhea Nausea/vomiting Joint pain/stiffness Bone Thinning Breast tissue tenderness or enlargement Emotional or cognitive changes Low blood counts Skin/nail changes Nervous system changes
Important Things to Know
  • These drugs bind to androgen receptors, which stops the androgens from driving tumor 
    growth.
  • Anti-androgens are most often used along with treatments that lower testosterone levels.
  • In some people, stopping an anti-androgen can stop cancer growth for some time, if the 
    anti-androgen is no longer working.
  • Some of these drugs may be used when the cancer is no longer responding to other types of 
    hormone therapy.
  • Hormone therapy may increase the risk of certain chronic diseases (e.g., high blood 
    pressure, diabetes, heart disease) in some men.
  • Long-term therapy can cause bone loss; your doctor may check your bone health.
  • Low blood counts may put you at risk for anemia, infection, or bleeding.
  • Stroke is rare, but your doctor will monitor your risk.