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If you have prostate cancer, and you are considering hormone therapy, also known as androgen deprivation therapy, you should understand that hormone therapy does not cure prostate cancer. Androgen (testosterone) deprivation only shrinks and slows down the growth of a prostate tumor. You will continue to have prostate cancer unless you have other forms of treatment that are used in combination with hormone therapy.
An orchiectomy is castration surgery. The testes produce most of the testosterone that males have in their bodies. By having an orchiectomy, your prostate cancer should be cured in time. Removing the testes greatly reduces the amount of testosterone circulating in your body. Prostate cancer needs testosterone to grow. Testosterone is as essential for the growth of a prostate tumor as oxygen is for a fire to grow. Testosterone production is decreased by 90 percent when you have surgical or chemical castration. Medications can be taken to block the remaining 10 percent of testosterone produced in the adrenals. The side effects of having an orchiectomy can be difficult to deal with; sterility, the loss of the libido and weight gain are pressing concerns that most men have. Prostate cancer is not likely to come back with the absence of free testosterone circulating in the body.
Luteinizing hormone-releasing hormone analogs
LHRH (luteinizing hormone-releasing hormone analogs) are injected every 3 to 4 months for the first year, and possibly just once a year thereafter, depending on the individual. LHRH is a form of chemical castration; this is an expensive treatment, but many men choose this over surgical castration. LHRH analog injections are just as effective as the orchiectomy at greatly reducing testosterone in the body. A side effect of using LHRH analog injections is that before it causes the testosterone to drop, it will cause an increase in testosterone levels. This increase in testosterone levels is called a flare. A flare can be dangerous if prostate cancer has metastasized to the spine, because a flare could cause rapid cancer growth that compresses the spinal cord. There are anti-androgen drugs that can be given a couple of weeks prior to the LHRH analog injections, which will prevent flares.
Anti-androgens are drugs that block androgens from being used by the body. Even with an orchiectomy, a small amount of testosterone is produced in the adrenal glands, which are located just above the kidneys. Anti-androgen drugs, such as Nilandron, Casodex and Eulexin are not used by themselves, but in conjunction with other treatments. Anti-androgens are used with orchiectomy surgery, and with luteinizing hormone-releasing hormone analog injections.
Estrogens are used to decrease testosterone levels. Estrogens are sometimes used when surgery isn’t an option. For instance, if your prostate cancer has spread to other parts of the body, estrogen therapy might be used in conjunction with anti-androgen therapy to prevent the body from producing testosterone. Whether hormones or surgery are used to stop androgen production, these treatments are very effective in helping a man become free of prostate cancer. Many men don’t really like taking estrogen because they sometimes get hot flashes, and suffer a loss of libido.
Early diagnosis and early treatment are essential for becoming cancer free. When prostate cancer is diagnosed early, many men don’t have to have surgery, because hormone therapy is often enough to cure prostate cancer in the early stages. When prostate cancer spreads to the lymph nodes, hormone therapy may help to slow down the growth of cancer, and it may even prolong life, but it may not completely kill the cancer. The orchiectomy and hormone therapy are good options to use if other forms of treatment were used and the cancer recurred.