Answering Important Questions about Hormone Therapy for Prostate Cancer
Revered cancer researcher, Charles Brenton Huggins discovered that hormone therapy can be used to regulate the spread of prostate cancer. The research revealed that removing the main source of testosterone, i.e. testicles can significantly inhibit the growth of cancer.
Huggins further found that prostate cancer cells could only grow with support from androgens. The testicles are responsible for the production of 90-95% of androgens in the human male. The rest 5-10% are produced by the adrenal glands.
How Does Administering Hormone Therapy Help?
The basic idea behind hormone therapy is to prevent the male body from producing androgens and/or hindering their activation. Once the androgen levels plummet, cancer slows down. Research has found that in 85-90% of the cases, hormone therapy has shrunk the tumor down to a non-threatening size.
Do understand that hormone therapy can not cure cancer. In fact, it doesn’t work for extended periods of time either. Certain cancerous cells don’t require androgens to spread, with time these cells will continue to grow. In such cases, hormone therapy won’t be effective any longer and you will need to switch to different treatment methods.
What are the Different Types of Hormone Therapy?
Broadly speaking, hormone therapy can be categorized into two types -
Drugs that stop the body from making androgens
Drugs that prevent the androgens from attaching to the cancer cells.
Often doctors administer both drugs to the patient to attempt a total androgen bock in the body. This is known as a combined androgen blockade.
Luteinizing Hormone-releasing Hormone Agonists (LHRH)
LHRH agonists are essentially chemicals that curb testosterone production in the testicles. Using LHRH agonists is often known as chemical castration. The effects however are completely reversible once you stop taking the medication.
Lupron, Trelstar, Vantas, Zoladex are some common drugs that need to be injected every 1-4 months. Viadur is an implant placed in the arm that needs to be readministered every year.
LHRH agonists do not come without side effects, the most prominent being low sex drive, hot flashes and gynecomastia, weight gain, fatigue, and losing muscles.
Anti-androgens
Anti-androgens target the 5-10% of androgens that are produced in the adrenal glands. These drugs don’t actually stop the hormones from being made but instead, stop them from attaching to the cancer cells. Anti-androgens are preferred because they tend to have less side effects as compared to LHRH. Casodex, Eulexin, and Nilandron are a few examples. These drugs can be taken regularly in pill form.
Another reason anti-androgens are popular is that LHRH agonists can cause an initial tumor flare. The sudden increase in the size of the tumor enlarges the prostate causing pain and difficulty in urination. Starting with anti-androgens and gradually transitioning to LHRH can take care of this problem.
Combined Androgen Blockade
As the name suggests, combined androgen blockade uses both LHRH agonists and anti-androgens to curb the production as well as effects of the hormones. Combined androgen blockade also addresses both hormones from the testicles and the adrenal glands.
However, as effective as the treatment is, hormone specialists say that the combined approach gives rise to more side effects. Not only does the patient have to deal with the loss of libido, hot flashes, and impotency but also frequent diarrhea, fatigue, and liver problems.
Orchiectomy
Orchiectomy is the medical term for the surgical removal of testicles. Orchiectomy is one of the earlier forms of hormone therapy against prostate cancer, even though it is not very popular today. Orchiectomy is a permanent procedure and thus avoided in favor of LHRH agonists and anti-androgens that give more or less the results. The side effects of this surgery are similar to LHRH shots, including gynecomastia (development of breasts), fatigue, weight gain, and loss of muscle mass.
In a select few cases, however, orchiectomy might be the right choice. A good example is someone who is tired of having to take shots every 3 to 4 months and is not bothered by the waning sex drive. Orchiectomy is also much cheaper in the long run.
What Happens After Hormone Therapy for Prostate Cancer?
The Broadway Clinic helps prostate cancer survivors to claim their bodies back from the unfortunate side effects of cancer treatment. Our Bio-identical Hormone Replacement Therapy (BHRT) replaces the lacking testosterone in the body with a synthetic alternative derived from plant sources. It restores muscle mass, sex drive, and psychological well-being. Testosterone replacement therapy is also effective against osteoporosis. To request an appointment with us, visit our website.
**Disclaimer: This content does not aim to provide any medical advice nor does it constitute or prescribe any doctor-patient relationship.