Hormone Therapy for Prostate Cancer

1 What is a Hormone Therapy for Prostate Cancer?

A treatment to stop the male hormone testosterone from reaching cancer cells in your body is called hormone therapy for prostate cancer which is also known as androgen deprivation therapy.

Most prostate cancer cells rely on testosterone to help them grow.

In this therapy, it will cut off or stop the supply of testosterone to reach the cancer cells leading to cancer cells dying or growing slowly. This may involve medication or surgery to remove the testicles.

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2 Reasons for Procedure

The main reason for hormone therapy for prostate cancer is to stop your body from producing the male hormone testosterone.

Your doctor may suggest this therapy as an option for different reasons or at different times during your cancer treatment.

Hormone therapy can be used:

  • In prostate cancer, that recurs after the treatment.
  • In advanced or metastatic prostate cancer to slow the growth of tumors or shrink cancer.
  • In those with a high risk of recurrence after initial treatment to reduce that risk.
  • In locally advanced prostate cancer to make external beam radiation therapy more effective.

3 Potential Risks

The potential risks of hormone therapy for prostate cancer include:

  • Increased body fat
  • Loss of muscle mass
  • Erectile dysfunction
  • Loss of sex drive
  • Hot flashes
  • Bone thinning which can lead to broken bones
  • Fatigue
  • Decreased body hair
  • Smaller genitalia and growth of breast tissue
  • Problems with metabolism
  • Changes in behavior

Your doctor may recommend that you take medications only until prostate cancer responds to the treatment to minimize the side effects of these medications. If the disease recurs, resume the use of these medications.

Your doctor may suggest intermittent dosing if:

  • There is evidence of spreading cancer but survival is a secondary factor for you compared with the quality of life.
  • You have an elevated level of prostate-specific antigen (PSA) in your blood but no other evidence of spreading cancer.

4 Preparing for your Procedure

In preparing for your hormone therapy for prostate cancer, you must follow your doctor’s orders. 

The approaches are:

  • Medications that stop your body from producing testosterone to prevent your body’s cells from receiving messages to make testosterone such as luteinizing hormone-releasing hormone (LHRH) or gonadotropin-releasing hormone (GnRH) agonists and antagonists
  • Medications that block testosterone from reaching cancer cells such as anti-androgens that are given in conjunction with LHRH agonists
  • Surgery to remove the testicles (orchiectomy) which are permanent and irreversible to reduce the testosterone levels in your body quickly

5 What to Expect

Here you can find out what to expect from your hormone therapy for prostate cancer.

LHRH agonist and antagonist medications stop your body from producing testosterone.

Every three months or six months, these medications will be injected into your muscle or under your skin or they can be implanted under your skin. These medications are:

After you received an LHRH agonist except for Degarelix, testosterone levels (flare) may increase briefly for a few weeks your doctor may suggest that you take an anti-androgen either before or along with an LHRH agonist to decrease the risk of flare. Anti-androgens block testosterone from reaching cancer cells.

These oral medications are usually prescribed along with an LHRH agonist or before taking an LHRH agonist and these include:

In orchiectomy which is performed as an outpatient procedure, your doctor will first give you anesthetics to numb your groin area and then he will make an incision and extracts the entire testicle then will repeat the procedure for your other testicle or you can choose for prosthetic testicles. There are risks such as:

  • Pain
  • Infection
  • Bleeding in all of the surgical procedures

Other medications can be used to block testosterone in the body when prostate cancer persists or recurs despite hormone therapy and these are:

  • Corticosteroids such as prednisone
  • Abiraterone (Zytiga)
  • Ketoconazole
  • Enzalutamide (Xtandi)

These other medications are mostly reserved for men with advanced prostate cancer when they no longer respond to hormone therapy treatment.

6 Procedure Results

The results of a hormone therapy for prostate cancer will be given by your doctor. This therapy does not cure the disease.

Despite hormone therapy, all prostate cancers that require hormone therapy will eventually recur or progress. By slowing the growth of prostate cancer for months or years is the main goal of hormone therapy.