Hormone Treatment for Prostate Cancer
Most prostate cancer cells (except for the poorly differentiated forms) are sensitive to and depend on the male hormone testosterone to grow. Hormone Therapy also known as Androgen Deprivation Therapy (ADT) prevents the testosterone from either being produced or reaching the prostate gland thereby slowing the cancer growth and reducing symptoms. Although it is not a permanent cure, hormonal therapy helps to delay disease progression.
Click to view Prostate Cancer UK video on What is Hormone Therapy for Prostate Cancer
When can Hormone Therapy be used
- in conjunction with other treatments like radiotherapy or surgery
- for advanced prostate cancers with metastases
- when the PSA starts to rise again after previous treatment
Types of Hormone Therapy for Prostate Cancer
There are several ways to prevent your testosterone hormone from having any effects on your prostate gland. Do discuss with your doctor, the most suitable method for your case.
1. Medications to stop testosterone production are known as Luteinizing Hormone-Releasing Hormone (LHRH) or Gonadotropin-Releasing Hormone (GnRH) agonists and antagonists. They prevent your body cells from receiving messages to make testosterone. These medications which need to be injected (either monthly, 3-monthly or 6 monthly) and they include;
- Leuprolide (Eligard, Lupron)
- Goserelin (Zoladex)
- Buserelin (Suprefact)
- Triptorelin (Trelstar, Decapeptyl)
- Histrelin (Vantas)
- Degarelix (Firmagon)
2. Medications to block testosterone from reaching prostate cancer cells are also known as anti-androgen medicine. They may also be given in conjunction with LHRH agonists to reduce the risk of a ‘testosterone flare or surge’. These include;
- Bicalutamide (Casodex)
- Nilutamide (Nilandron)
- Flutamide ((Drogenil)
- Cyproterone (Cyprostat)
- Nilutamide (Nilandron)
3. Orchiectomy is the removal of both testicles to prevent any production of testosterone and is usually performed as an outpatient procedure. The procedure reduces the need for medication.
Click to view ProstateCancerCanada video on Hormone Treatment for Prostate Cancer
4. Other androgen-blocking medications may be required when the prostate cancer persists or have become resistant to the above medications. These medication include;
- Abiraterone (Zytiga)
- Enzalutamide (Xtandi)
- Apalutamide (Erleada)
- Darolutamide (Nubeqa)
- Steroids
Bone Targeted Therapy such as Bisphosponates, Immunotherapy or Chemotherapy using Doxetaxel (Taxotere) or Cabazitaxel( Jevtana) maybe required if there is metastasis cancer spread (for example to the bone).
Side effects of hormone therapy
- Weight gain with increase body fat
- Breast enlargement or tenderness
- Fatigue
- Muscle weakness
- Loss of libido with erectile dysfunction
- Mood changes
- Bone thinning
- Heart disease
See your Urology Specialist to discuss your treatment options
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