Hormonal Treatment

Several novel hormonal agents are currently in development for the treatment of prostate cancer. Promising new classes of agents include:

1. Estrogenic strategies: These agents have estrogen-like properties that are thought to decrease testosterone production by the testes while possibly also having direct anti-tumor effects by binding to proteins on the cancer cells (estrogen receptors).   Drugs in this class include the herbal alternative strategy PC SPES, as well as estrogen receptor beta agonists.  

2. Adrenal androgen inhibitors: Up to 10 % of serum testosterone is produced by the adrenal glands.  In some patients who have been treated with testicular testosterone ablation (i.e., castration or LHRH agonist), this small amount of testosterone can become important.  Therefore, strategies to inhibit this remaining testosterone production with drugs that suppress adrenal activity has been studied.  Most recently, studies using high doses of the anti-fungal ketoconazole (Nizoral) have been promising.  Future investigations with aromatase inhibitors and other more targeted strategies may be available in the future.  The relationship between endocrine factors and  the growth and differentiation of cancer cells is an area of intense reasearch.  As our understanding grows it will lead to the development of many new and potentially useful hormonally active agents that may be effective in the treatment of some prostate cancers.