Hormone therapy is one of the most frequently used treatments for advanced or recurrent prostate cancer. There are several ways to administer it, all aiming to reduce androgen hormones, such as testosterone, which stimulate the growth of cancer cells. In this article, we will focus specifically on two approaches: continuous hormone therapy and intermittent hormone therapy.

This will help you better understand:

• The two approaches to hormone therapy
• How they work
• Situations in which they are indicated
• Their advantages and disadvantages

Medical review by uro-oncologist Dr. Paul Toren, December 2025

Continuous hormone therapy: prolonged suppression

Receiving a prostate cancer diagnosis inevitably raises many questions, especially when you are offered continuous hormone therapy.

Behind this technical term is a well-established approach: slowing cancer progression by acting on one of its main energy sources—testosterone.

How does it work?

Prostate cancer is hormone-sensitive, meaning it needs testosterone to grow. Think of testosterone as the fuel that powers your prostate cancer.

Continuous hormone therapy works by drastically lowering the level of this hormone in the body. Two methods can be used:

• Blocking testosterone production with injections or implants
• Preventing testosterone from acting on cancer cells using oral tablets

This treatment is called “continuous” because it is administered without interruption, often for several years.

When is it indicated?

This approach is often used:

• For metastatic cancer
• If the cancer recurs after initial treatment (surgery or radiotherapy)
• In combination with other treatments, such as radiotherapy, to increase their effectiveness
• For some older or frail patients when surgery is not feasible

Each treatment plan is tailored to the patient’s situation, based on cancer stage, aggressiveness, and overall health.

Advantages and disadvantages

Like any treatment, continuous hormone therapy has several advantages but can cause side effects, often related to the drop in testosterone.

Advantages

• Significantly slows cancer progression and allows consideration of additional treatments later
• Can stabilize the disease for many years
• Relieves certain symptoms, especially those related to bone metastases
• Reduces tumor size and PSA levels (prostate-specific antigen)
• Relatively easy to administer (monthly injections according to protocol or daily oral tablets)

Disadvantages

• Hot flashes, night sweats
• Decreased libido and erectile dysfunction
• Persistent fatigue
• Loss of muscle mass
• Weight gain
• Mood changes, anxiety, irritability, sleep difficulties
• Bone weakening (osteoporosis)
• Metabolic changes (e.g., cholesterol, lipids) or high blood pressure

These side effects are known and closely monitored. Your medical team can offer strategies such as tailored exercise, psychological support, balanced nutrition, or complementary treatments.

Intermittent hormone therapy: breaks for better recovery

Intermittent hormone therapy offers a more flexible and personalized alternative, designed to control the disease while preserving quality of life.

How does it work?

Like continuous therapy, intermittent hormone therapy aims to reduce testosterone levels in the body. The difference? It alternates active treatment periods with breaks, called “therapeutic windows.”

During active phases, injections or tablets lower testosterone levels. When PSA (a blood cancer marker) drops sufficiently, treatment is paused and only resumed if PSA rises above a certain threshold. The body can then recover during these breaks.

Who is it for?

This treatment may be suitable for:

• Recurrence, with rising PSA after surgery or radiotherapy
• Advanced but stable cancer in selected patients
• Reducing long-term side effects of continuous hormone therapy without compromising effectiveness

It is especially appropriate for men whose cancer progresses slowly or whose PSA remains under control during breaks.

Advantages and disadvantages

Advantages

• Reduces side effects related to hormone deprivation during breaks
• Restores energy and reduces fatigue
• Improves libido and sexual function
• Preserves muscle mass and bone strength
• Promotes better mood, concentration, and sleep
• Could, in theory, delay the development of treatment resistance, prolonging effectiveness over time

Disadvantages

• Not suitable for all patients
• Side effects return when treatment resumes; not all men fully recover during breaks
• Requires close medical monitoring (blood tests, PSA, clinical exams)
• Requires understanding the protocol, as treatment resumption depends on results
• Some patients may feel anxious during breaks, even if cancer is under control

Continuous or intermittent hormone therapy?

Studies show that for selected patients, intermittent therapy can be as effective as continuous therapy without compromising overall survival.

However, each patient is unique, and the choice depends on:

• Extent of the disease (e.g., continuous therapy is often preferred for patients with visible metastases on imaging)
• Speed of progression and cancer grade (e.g., Gleason score)
• PSA levels
• General health and patient preferences

This decision is made with your medical team to balance effectiveness and quality of life.

Conclusion

Hormone therapy remains a cornerstone of prostate cancer treatment. Continuous or intermittent, each approach has its advantages and meets different needs.

The key is to clearly understand the objectives, benefits, and side effects to actively participate in decisions about your treatment.

If your doctor recommends hormone therapy, take the time to ask about treatment duration, possible side effects, and ways to manage them. Discuss your priorities and lifestyle to ensure the plan is tailored to your situation.

At PROCURE, we believe that better understanding leads to better living with the disease. Our professionals are here to support you and answer your questions, seven days a week. Contact us at 1-855-899-2873 or visit our website procure.ca