Hormone Therapy

What is it?
  • Hormone therapy works by depriving cancer cells of the male hormones (androgens) they need to grow.
  • Affects the whole body rather than a particular area.
Most often used to treat:
  • Cancer that has spread outside the prostate
  • Recurrence of prostate cancer after another therapy has been used
  • Men who are at a high risk of experiencing cancer recurrence after surgery or radiation therapy.
What is done?

There are two methods of hormone therapy:

  • Surgical removal of the testicles to prevent testosterone production (rarely used).
  • Medication.
The 2 main categories of medication are:
  • Luteinizing hormone releasing hormone (LHRH) analogues and LHRH agonists, both of which interfere with androgen production.
  • Anti-androgens which block the effects of male hormones on prostate cells.
What to expect?

Hormone therapy is used in various ways to treat prostate cancer.

Combination hormone therapy
Anti-androgens are combined with either LHRH analogue therapy or surgical removal of the testicles.

Intermittent hormone therapy
Hormone therapy is stopped once PSA number is lowered and stabilized. It then resumes when PSA number increases again.

Neoadjuvant hormone therapy
Hormone therapy is given before local treatment. This reduces the size of the tumour to make the “main” treatment potentially more effective.

Adjuvant hormone therapy
Used directly after surgery or radiation to treat cancerous cells that may remain.

Side effects and risks

  • Possible side-effects include:
    • Hot flashes
    • Erectile dysfunction
    • Loss of energy, general weakness
    • Breast enlargement and tenderness
    • Irritability
    • Emotional disturbance including depression
    • Headache
    • Itching, dry skin, rash
    • Gastrointestinal issues: diarrhea, nausea,
    • Vomiting
    • Loss of muscle mass
    • Weight gain (mainly due to increased body fat)
    • Shrinkage of testicles
  • Long-term use may lead to:
    • Osteoporosis
    • Lower blood counts or “anemia”
    • Higher levels of “bad” lipids in the blood
 
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