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Hormone Therapy

Hormone Therapy Prostate Cancer Treatment

Many patients are concerned about the impacts of radiation on their healthy tissue and their quality of life and seek out alternatives to either external beam or prostate seed implant treatment. There is a therapy that doesn’t involve radiation, and that is hormone therapy. Instead of directly assaulting the affected area, hormone therapy combats cancer a different way, by altering the body’s production of testosterone. This hormone provides the fuel that helps cancer cells grow and reducing the body’s supply of it has the benefit of slowing cancer growth.

There are a few different scenarios in which hormone therapy might be a good option for a patient. Frequently, it is used in conjunction with external beam radiation to increase the effectiveness of that treatment, as well as reduces the rate of recurrence of prostate cancer. In fact, hormone therapy will often be the first line of defense if PSA levels start rising after any treatment. Another option is that hormone therapy will be used in metastatic cases, to shrink the cancer and slow the growth, in order to provide relief of the symptoms to the patient.

Hormone therapy can take a few different forms. A treatment plan may utilize different combinations of these medications in order to achieve the best effect. The first type of medication is called luteinizing hormone-releasing hormone (LHRH) or gonadotropin-releasing hormone (GnRH) agonists and antagonists. In layman’s terms, these medications block the signal that tells the body to produce testosterone. With these medications, the testicles produce far less testosterone, which hinders the growth of any tumor.

Another type of medication commonly used is called the anti-androgens. The goal of these medications is to prevent any testosterone in the body from reaching the cancer cells. These drugs are rarely used on their own as they can cause a temporary spike in testosterone, which is not beneficial during hormone therapy.

A final and more extreme option is to remove the testicles completely, called orchiectomy. This is effective because the testicles are the producer of testosterone, and removal is a rapid way to cut off production. Obviously, this option is permanent, although no additional hormone therapy is required after the procedure. For aesthetics, prosthetic testicles are available.

The administration of hormone therapy is relatively simple. LHRH agonist and antagonist drugs are generally injected, normally monthly but can be as rarely as every three or six months. In addition, an implant can be put under the skin that will slowly release medication over an extended period of time, which may be preferable to some patients. Anti-androgens are oral medications.

This gives hormone therapy the advantage of not requiring a lot of time in the hospital or prostate cancer clinic, but there will be regular follow-up visits to check on progress. In addition, because the male body uses so much testosterone, hormone therapy does have side effects to monitor. To help combat the side effects, a doctor may recommend intermittent dosing, which involves patients taking drugs in a cycle, in hopes of alleviating any negative effects.

What are the Advantages of Hormone Therapy?

  • Treatment is non-invasive. Medications are either injected infrequently (monthly at the most), implanted under the skin or taken orally.
  • Hormone therapy is not time-intensive. Outside of follow-up visits and monthly injections, treatment can be done at home.
  • No radiation is involved with hormone therapy.
  • This treatment may be used in conjunction with radiotherapy to produce stronger results.
  • Hormone therapy can prevent the recurrence of cancer after other treatments.

What are the Disadvantages of Hormone Therapy?

  • Patients may experience fatigue, depression, and decreased mental acuity. These symptoms can be managed with an antidepressant, normally mild. Exercise has also been shown to alleviate these symptoms.
  • The male body uses testosterone to build muscle and bone mass, and the suppression of the hormone may cause the decrease of both. Strength training has been shown to help prevent muscle and bone loss.
  • Weight gain is also common. Testosterone is a key part of the metabolic system, and the suppression of it can lead to increased weight.
  • Sexual dysfunction is very common with hormone therapy, as testosterone is critical to libido. Medications are widely available to combat any erectile dysfunction.
  • Other side effects may include hot flashes, anemia or growth of excess male breast tissue.