Hormonal blockade (androgen deprivation therapy, ADT) with oral agents (e.g. Androcur, Cosudex) often in combination with injectable depot preparations (e.g. Zoladex, Eligard or Lucrin) have a role in several areas of prostate cancer management.
They may downsize the prostate prior to radiotherapy, may be used for 12 - 24 months in combination with radiotherapy, but are also used in the ongoing treatment of advanced or metastatic prostate cancer. Usual side effects may include hot flushes, tiredness, low libido, erectile dysfunction, weight gain, mood swings, breast tenderness, and in the longer term reduced bone mineral density, reduced glucose tolerance (prediabetes) or "metabolic syndrome". ADT may be used continuously or intermittently with equivalent cancer response, but ultimately disease resistance and PSA progression will occur in those with metastatic disease. Chemotherapy is then used to achieve further periods of disease response. Chemotherapy given by a medical oncologist may be intravenous or oral, depending on the disease stage, the prior medicines used, the health of the patient, and the current government subsidisation rebates through the PBS.