There are a number of different flavors of hormone therapy (ADT) used to treat advanced prostate cancer. However, they could be summed up and put into two different categories.

1- The use of luteinizing hormone-releasing hormone (LHRH) agonist therapy (drugs like Lupron and Zoladex) along with short term antiandrogen (AA) flare protection

2- Degarelix, a gonadotrophin-releasing hormone antagonist which does not require the use an antiandrogen (AA) flare protection drug because it does not cause a surge in testosterone levels.

In a research study where individual patient data from two phase III trials had been pooled to compare the one year efficacy of degarelix monotherapy vs. combined LHRH agonist + AA for flare protection it was determined that LHRH agonist + AA therapy may not achieve similar disease control as degarelix monotherapy during the first year of therapy in patients at high risk of symptomatic disease progression.

Translation: Degarelix, a gonadotrophin-releasing hormone antagonist without the use of an antiandrogen to block a testosterone flare is probably the superior hormone therapy treatment for men with symptomatic disease progression.

Discuss this with your doctor. Degarelix is the more expensive treatment, but it is superior both in controlling PSA progression free survival and in the negative biomarker score of serum alkaline phosphatase.

E. David Crawford, Jan-Erik Damber, Anders Malmberg, Bo-Eric Persson, Laurence Klotz, and Peter Iversen at the 24th International Prostate Cancer Update – February 19 – 22, 2014 – Cascade Conference Center – Vail, Colorado USA

Joel T. Nowak, M.A., M.S.W.