Androgen Deprivation Therapy (ADT)
ADT is a systemic modality that treats—and affects—the entire body, not just the localized area of the prostate gland. This treatment impedes the production of hormones (androgens) and blocks the body from absorbing any androgens such as testosterone produced naturally in your body.
ADT is effective because prostate cancer cells develop and grow in the presence of testosterone, the male androgen produced mostly by the testes. Limiting production of testosterone and preventing any androgen that is produced from interacting with the cancer cells, forces the cancer cells into stasis, possibly delaying their harmful effects by years. In effect, ADT, when it employs medications (see below) causes the male body to experience castration without surgery.
Unlike surgery, when chemically induced ADT is no longer required the positive emotional and physical benefits of testosterone may return. However, there is no guarantee that the testosterone will eventually return and no way to know how long the return might take.
ADT is often called “hormone therapy.” This is an inaccurate description. In fact, ADT should be called “anti-hormone therapy” because its function is to halt production of the hormone testosterone in a man’s body.
Your doctor will usually recommend ADT if:
- — Salvage therapy fails, or
- — You are initially diagnosed with advanced prostate cancer with a PSA above 10.0, or
- — There is other evidence that the cancer has already moved beyond the prostate gland (such as positive scans or symptoms such as blood in the urine), or
- There a bio-chemical recurrence with a PSA greater than 10.
Prostate cancer that responds to ADT is said to be hormone- or androgen-dependent. Unfortunately, in most cases, the cancer eventually “learns” how to grow without requiring testosterone derived