Hormonal Therapy When Cancer Has Spread Beyond The Prostate Gland

Hormonal Therapy When Cancer Has Spread Beyond The Prostate Gland
Once prostate cancer has spread beyond the prostate gland localized therapies are no longer sufficient to stop the growth of the cancer and treatment generally involves a combination of both radiation therapy to kill the cancer cells and hormonal treatment to slow the growth of the cancer by cutting off its fuel supply.

The aim of hormonal therapy is to cut off the production of the male hormones, such as testosterone, which fuel the growth of prostate cancer, or to render them ineffective, and this essentially means castration, either surgically or by other medical means such as using an antiandrogen drug to block the circulation of male hormones in the blood.

There are various different approaches when it comes to hormonal therapy and it is often a case of testing different combinations of drugs to discover what works best in individual patients. One approach is what is known as a 'maximum androgen blockade' which is a blanket approach using a wide range of drugs combined with either surgical or medical castration. This approach has proved effective in some patients but many doctors question whether it is in fact any more effective than standard hormonal therapy.

When it comes to considering whether or not to opt for the surgical removal of the testes or to choose medical castration this is not always an easy decision as surgical castration is understandably a major and life-changing step for many men. It is however an ultimate solution to the problem of the production of male hormones, unlike hormonal therapy which will simply block those hormones for as long as the therapy continues. If however you stop the therapy then, although it will generally take some time for cancer which has been slowed or halted to begin growing again, it will inevitably do so within a matter of months or at best within two or three years.

In either case there is also often a problem with some cancer cells which do not require testosterone to grow and here it is often necessary to use a second tier of hormonal drugs such as progesterone or hydrocortisone to deal with the problem.

One approach with hormonal therapy is not to use this simply as a treatment for advanced prostate cancer but in fact to start hormonal therapy as soon as prostate cancer is diagnosed, even if it is confined to a small area of the prostate gland and is slow growing. The aim here is to slow the growth of the cancer, and in some cases to actually shrink the tumor, so that it can possibly be confined to the prostate gland where it can do relatively little harm for the remainder of a patient's life.

Despite the fear which surrounds prostate cancer, because it often appears late in life and does little if any harm as long as it is contained within the prostate gland, many men live quite happily with the disease and indeed die from a variety of other total disassociated conditions, including simple old age.

ProstateProblemCenter.com provides information on a variety of prostate problems and covers topics such as enlarged prostate treatment and the therapeutic use of prostate massage

Hormone Therapy Treatment - Help For Prostate Cancer

Prostate cancer hormone therapy treatment is also known as androgen deprivation therapy (ADT). When dealing with prostate cancer and ways to treat it, you want to concentrate on reducing the levels of male hormones in the body. These hormones include testosterone and dihydrotestoterone. While not directly causing prostate cancer, the hormones stimulate the malignant cells to grow and multiply. Research has shown that by reducing the hormones that are produced by the testicles prostate cancer has shrunk in the gland or has slowed down in its growth.

Only the doctor can decide who will benefit the most from hormone therapy treatment. Patients who are not able to have prostate surgery or radiation treatment because the cancer has spread beyond the confines of the prostate are good candidates for hormone treatment therapy. Prostate cancer hormone therapy treatment can be used in addition to radiation therapy and also if there has been a re occurrence of the cancer.

Types of prostate cancer hormone therapy treatment

Orchiectomy - surgical castration - is actually a form of hormone therapy because by surgically removing the testicles you are removing the hormones that cause the stimulation of cancerous cell growth. This usually helps slow the growth and sometimes actually shrink the cancer. This procedure is done as outpatient surgery and for those patients who are concerned over how they will look after the surgery, artificial sacs that look and feel like natural testicles can be inserted into the scrotum as replacements. Side effects of this procedure include but are not limited to: reduced or absent libido and impotence; hot flashes; anaemia; loss of muscle mass; weight gain; fatigue; and depression. All of these side effects can be prevented and treated.

LHRH (luteinizing hormone-releasing hormone) analogs are an option over orchiectomy. Most men opt for this treatment even though it costs more and requires more frequent visits to the doctor. LHRH analogs lower testosterone levels without the need to remove the testicles. The analogs are implanted beneath the skin monthly or in multiple month doses. Popular medications include Lupron, Viadur, Eligard, Zoladex, and Trelstar. Hot flashes, osteoporosis, and side effects similar to those found with the surgical castration can be found in patients receiving these treatments. Occasionally a patient's testosterone levels will flare when these treatments are started and can be counteracted by anti-androgen medication.

LHRH antagonists, such as Plenaxis, work like the LHRH analogs, but they seem to work faster and do not cause the testosterone levels to increase and cause the tumour to suddenly grow. Less than 5% of patients have an allergic reaction to the use of the antagonists and it has been approved for use in men whose prostate cancer has advanced and cannot take other treatment and refuse surgery. The side effects are the same and this hormone therapy is administered in the doctor's office as injections in the buttocks.

Anti-androgens block the body's ability to respond to androgens. Androgens are also produced by the adrenal glands, although not in the same amount as what is produced by the testicles. This treatment is administered in the form of pills and is commonly combined with the other treatments. Doctors are actually testing the use of just anti-androgens in treating prostate cancer. Diarrhea, nausea, liver problems and tiredness are some of the side effects of the medication.

Controversies in hormone treatment therapy

As with all medical treatments and medication uses, there are some controversies surrounding prostate cancer hormone treatment therapy. There is a question as to the benefits of starting hormone therapy as soon as the cancer is detected or waiting until there is more clinical proof that it helps in early stages. Not all doctors believe in using the hormones continuously, citing that the patient's body could become resistant to the treatment.

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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/

Success with Hormone Therapy for Prostate Cancer

Hormone therapy is known as one of the treatments for prostate cancer. We have heard success stories with hormone therapy for prostate cancer patients from Internet and medical publications. Here we discuss why hormone therapy can be applied to treat prostate cancer. The prostrate gland is found near the base of the urethra.

This is the tube that carries urine from the bladder out through the penis. The front end of the prostrate gland surrounds the urethra and the rear part of the gland presses against the rectum. The prostrate gland is found in the males and is susceptible to tumor growths. These tumors can be benign or malignant. Malignant means that the tumor is cancerous and life threatening.

Faulty Genes Put Right With Hormones
Having a cancerous prostrate tumor is no cause for alarm because if the tumor is diagnosed well in advance, for which there are many symptoms the layman can understand, the prostrate gland can be surgically removed along with the tumor. Thus, one can prevent the spread of the tumor to other parts of the body through the blood and lymphatic system.

It is very rare to find a patient under fifty to have prostrate cancer. The patient can become weary of a tumor on the prostrate gland if he finds the following symptoms: dribbling before or after urinating, feeling that the urinary bladder is never empty completely, discomfort or pain while urinating and passing of blood sometimes while urinating, false calls or frequently wanting to urinate without actually urinating.

Getting Rid Of the Gland

Apart from having the prostrate removed surgically, there are some hormone treatments for prostrate cancer as well. Some of these hormone treatments have known to have produced dramatic results. But, then it is the stage of the disease as well as the age of the person who is treated that also counts.

Doctors all over the world have known for a long time now that cancer can be treated with hormones as prostrate cancer has been known to be hormone or gene related. For instance, men who have had prostrate cancer in the family are more likely to contract the disease that men who have no family history of prostrate cancer.

Even men with the history of breast cancer in the family run the risk of developing prostrate cancer. This led to research on treating cancer with hormones. Research has shown that men live longer with prostrate cancer if it is treated with hormone therapy along with radiation treatment.

The standard hormone treatment is for three years but in many cases dramatic results have come about within six months of the treatment. Researchers from Boston's Brigham and Women's Hospital discovered that men treated with six months of androgen suppression therapy in addition to radiation improved faster and better than men treated with only radiation.

Prostate cancer can be treated. Click here for more information on hormone therapy for prostate cancer. Read also other options for prostate cancer treatment here. We provide facts and information about prostate cancer for free.