Prostate Cancer Treatment
Prostate cancer is the most common cause of malignancy and is the leading cause of death due to cancer in men. About 85 percent of American men with this malignancy are diagnosed early and are treated with surgery and radiotherapy. Fortunately, when diagnosed and treated early survival rate is high.
In some men, though, prostate cancer may be found in its late stages when the tumor cells have spread to the different parts of the body. This may occur because tumors of the prostate grow quite slowly and symptoms may be missed or disregarded. In these cases, surgery and radiotherapy may not be enough to treat the disease.
Prostate cancer hormone therapy may be needed when cancer cells have metastasized (spread) to other parts of the body like the lymph nodes, bones, liver and lungs. Since male hormones called androgen and testosterone support the growth of these tumors reducing their levels surgically and pharmacologically may delay or control the growth and spread of cancer.
What is Hormone Therapy?
Controlling hormonal levels entails significantly reducing testosterone and androgen levels either:
- Surgically - by removing the testicles (orchiectomy) where testosterone is produced, or
- Pharmacologically – by using drugs like flutamide, bicalutamide, nilutamide and finasteride to block synthesis of the male hormone by the adrenal glands.
Some urologists do both surgical and chemical castration (using a synthetic brain hormone analog) to deprive the prostate of hormonal support for growth.
Another strategy is to give the patient with advanced prostate cancer estrogen to counter the effects of testosterone.
Benefits and Risks of Hormone Treatment
Although total cure is unlikely for advanced prostate cancer with metastasis, it is estimated that hormonal manipulation shrinks the tumor in 85 to 90 percent of patients. This results in delay of cancer progression, reduction of symptoms like pain and urinary problems and an increase in survival rate.
However, aside from controlling the disease there are some side effects and risks involved in the treatment such as:
- Nausea and vomiting
- Hot flashes
- Swollen and tender breasts
- Erectile dysfunction
It is also possible that one’s prostate cancer may be resistant to hormone therapy and the urologist may prescribe chemotherapy instead. This type of treatment involves the use of drugs that kill cancer cells but may affect normal cells as well, producing unwanted side effects.
Research and Controversies on Hormone Therapy
Some debates still exist regarding the use of hormone therapy for prostate cancer such as:
- The benefits of using one drug versus a complete androgen blockade regimen to control cancer
- The benefits of early versus late hormone treatment to prevent complications
- The benefits of continuous versus intermittent hormone therapy to improve quality of life
Clinical trials are ongoing for improving prostate cancer hormone therapy. Several drugs with fewer side effects are still being tested and are awaiting FDA approval. These provide a brighter hope for patients suffering from advanced malignancy in the prostate.
UrologyHealth.org, “Hormone Therapy for Prostate Cancer”, https://urologyhealth.org/adult/index.cfm?cat=04&topic=90
WebMD, “Prostate Cancer: Hormone Therapy”, https://www.webmd.com/prostate-cancer/hormone-therapy