Learn about Hormone Therapy for Prostate Cancer

2010-08-31

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Prostate Cancer and its Cause

The prostate is located below the bladder surrounding the urethra. It is a walnut-shaped gland that produces the seminal fluid.(Click on image to enlarge.)

Prostate cancer occurs when abnormal cells develop and divide uncontrollably in the prostate, even though the body does not require them. The change allows those unwanted cells to stay alive, while others die. The buildup of abnormal cells leads to tumors, which begin to attack the adjacent tissue.

Symptoms

Signs and symptoms that might occur include:

Swollen legs
Difficulty starting urination
Discomfort in the pelvic area
Bone pain
Blood in the semen and urine
Reduced urine flow

Androgens and Hormone Therapy

Researchers have found that prostate cancer depends on male hormones, called androgens, to thrive. These hormones serve to produce the sexual characteristics of a man, such as a deep voice, muscle mass, and facial hair. Various studies have revealed that hormone therapy for treatment of prostate cancer is an effective alternative to radical treatments, like radiation or surgery, in certain groups of patients.

Glands in the body create chemical substances known as hormones that influence other tissues. In adult males, roughly 90% of their androgens are produced in the testes, while the rest are produced in the adrenal glands.

Hormone therapy for prostate cancer is normally recommended for men whose cancer has spread to other parts of the body, are older, have other serious health conditions or whose cancer is slow growing. The treatment keeps the body from producing androgens and testosterone that make cancerous cells flourish. The therapy also obstructs the effects of those hormones and stops the hormonal supply that helps eradicate cancer cells.

The decision on which treatment path to follow is a very personal decision. The biggest factor in your decision should be whether the cancer will cause you insurmountable problems. If the answer is yes, then a more radical treatment might be more suitable. Hormone therapy does have side effects, such as impotence and incontinence, and you should also determine whether those are side effects that you want to live with before making a decision.

Treatment

Hormone therapies can be applied in various degrees of the cancer. Several of them include:

Luteinizing hormone-releasing hormone agonists (LH-RH agonists)

These are medications that make your body stop producing androgens and testosterone in the testes. These medications include histrelin (Vantas), triptorelin (Trelstar), leuprolide (Eligard and Lupron), and goserelin (Zoladex), and degarelix (Firmagon). Side effects include loss of muscle, painful breasts, hot flashes, loss of libido, fatigue, weight gain and drops in HDL (good cholesterol) levels.

Orchiectomy

Orchiectomy is considered the traditional hormone therapy for prostate cancer. It involves surgical castration of the testicles to stop the production of androgens and testosterone. It is effective to lower the hormones significantly. Several side effects that can possibly occur are similar to those of LH-RH agonists including painful breasts, weight gain, loss of libido, fatigue, drops in HDL (good cholesterol) levels, and loss of muscle.

Anti-androgens

These medications can affect the hormones produced in the adrenal glands. They never prevent the body from producing the hormones, but they prevent the hormones from stimulating cancerous cells. These come as oral medications such as Eulexin, Casodex, and Nilandron. Side effects include fatigue, nausea, diarrhea, and tenderness of breast. Unlike LH-RH agonists and orchiectomy, many men prefer this treatment because it does not reduce the libido.

Combined Androgen Blockage

This therapy applies LH-RH agonists to anti-androgens or an orchiectomy. They can avoid the risk of the cancer by decelerating its progress and keeping the body’s ability from using the hormones. Their side effects include impotence and loss of libido.

Prognosis

Stage, grade and growth rate of the cancer can determine the prognosis. Age, overall health and other medical conditions will also play a part in the prognosis. The American Cancer Society recommends that older men or men with other health issues with a slow-growing cancer “might find it helpful to think of prostate cancer as a chronic disease that will probably not lead to your death but may cause symptoms you want to avoid.”