Hormone Therapy for Prostate Cancer

Hormone therapy, also known as androgen deprivation therapy (ADT), is a treatment for prostate cancer that aims to reduce the levels of male hormones, such as testosterone, in the body. Prostate cancer cells are often fueled by these hormones, so reducing their levels can help slow or stop the growth of the cancer.

How Hormone Therapy Works

Hormone therapy works by blocking the production or action of androgens, such as testosterone and dihydrotestosterone (DHT). This can be achieved through various methods, including:

• Luteinizing hormone-releasing hormone (LHRH) agonists: These medications, such as leuprolide and goserelin, stimulate the production of LHRH, which in turn reduces the production of testosterone.
• Luteinizing hormone-releasing hormone (LHRH) antagonists: These medications, such as degarelix, directly block the action of LHRH, reducing testosterone production.
• Anti-androgens: These medications, such as bicalutamide and flutamide, block the action of androgens on prostate cancer cells.
• Orchiectomy: This is a surgical procedure that involves removing one or both testicles, which produce testosterone.

Types of Hormone Therapy

There are several types of hormone therapy used to treat prostate cancer, including:

• Continuous androgen deprivation: This involves continuous treatment with LHRH agonists or antagonists.
• Intermittent androgen deprivation: This involves alternating periods of treatment with LHRH agonists or antagonists with periods of no treatment.
• Combined androgen blockade: This involves combining LHRH agonists or antagonists with anti-androgens.

Benefits and Risks

The benefits of hormone therapy for prostate cancer include:

• Reducing the size of the tumor
• Slowing or stopping the growth of the cancer
• Relieving symptoms, such as pain and urinary problems

The risks and side effects of hormone therapy include:

• Hot flashes
• Loss of libido
• Erectile dysfunction
• Weight gain
• Loss of muscle mass and strength
• Osteoporosis
• Anemia
• Increased risk of cardiovascular disease

Who is a Candidate for Hormone Therapy

Hormone therapy may be recommended for men with:

• Advanced prostate cancer that has spread to other parts of the body
• High-risk localized prostate cancer
• Recurrent prostate cancer after initial treatment

Monitoring and Follow-up

Men undergoing hormone therapy for prostate cancer require regular monitoring and follow-up, including:

• PSA tests to monitor the level of prostate-specific antigen in the blood
• Imaging tests, such as CT scans or bone scans, to monitor the size and spread of the tumor
• Regular check-ups with a healthcare provider to monitor side effects and adjust treatment as needed