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November 19, 2007

Hormone Therapy for Prostate Cancer

For prostate cancer treatment we give the patient hormones that will suppress the male hormones (andrones) in their body. Androgens (male hormones) are produced mainly in the testicles. Sometimes androgens will stimulate the growth of prostate cancer and speed up the growth of the cancer cells. If the levels of the androgens is lowered then the cancer will grow much slower and possibly shrink. Hormone therapy is not meant to cure the cancer in the prostate but if used in conjunction with other therapy such as radiation or surgery if their is a risk of recurrence.

There are numerous ways that the androgen levels can be lowered in the bloodstream:

Orchiectomy - is the surgical removal of one or both of the testicles which are the main source of androgen production in the male body. By removing the testicle or testicles the levels of male hormones will drop enough to slow the growth of the cancer

Luteinizin hormone-release hormone analogs (LHRH) - often chosen instead of having an orchiectomy, LHRH analogs are injected or inserted as small implants underneath the skin. These injections are usually given every month or ever 3, 4, 6 or 12 months. The LHRH analogs that are used most of the time are Lupron, Viadur, Eligard, Zoladex or Trelstar.

Antiandrogens - are given to block the action of the androgens (production of male sex characteristics). Antiandrogens are given in daily pill form and the drugs used are Eulexin, Casodex, and Niandron. Antiandrogen treatments is often used in conjunction with an Orchiectomy because even after the orchiectomy there are sill androgens that will be produced by the adrenal glands.

Estrogens - largely replaced by LHRH therapy because of severe side effects, the use of estrogens (hormones that produce female sex characteristics) was often used in the past as a substitute for Orchiectomy

Side Effects of Hormone Therapy

The side effects for Orchiectomy and LHRH treatment are basically the same:

-reduced or no libido (sexual desire)
-impotence
-hot flashes (these may go away with time)
-breast tenderness and growth of breast tissue
-osteoporosis (weakening of bones) leading to bone fractures
-anemia (low red blood cell counts)
-decreased mental acuity
-loss of muscle mass
-weight gain
-fatigue
-decrease in HDL ("good") cholesterol
-depression
The Side Effects of Antiandrogen Treatment
-diarrhea
-nausea
-liver problems
-tiredness

*Note that the biggest difference between the side effects of LHRH treatment and Antiandrogen treatment is when Antiandrogens treatment is given alone their are less sexual side effects. The patients libido and potency can still be maintained.

Many of the side effects noted above can be treated so if they do arise consult with you doctor about what can be done to reduce them.
Steven Wallace provides information about Prostate Diseases and Prostate Cancer screening, diagnosis and treatment options at
http://prostate-answers.com/

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