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All cells need fuel to grow and survive. The same is true of prostate cancer cells. So, it follows that if we deprive those same cells of the fuel they depend upon, they won’t be able to grow. The cancer will be stopped in its tracks.
This is the theory upon which hormone therapy is based. Because the hormone testosterone functions as the main fuel for prostate cancer cell growth, it is a common target for therapeutic intervention in men with the disease.
Hormone therapy – also known as androgen-deprivation therapy or ADT – aims to stop testosterone from being released or to prevent the hormone from acting on the cells. It can be used at any stage of prostate cancer – before, after and during local treatment and in men with advanced stages of the disease.
The good news regarding hormone therapy is that the majority of cancer cells respond to the removal of testosterone. Unfortunately, there are some that don’t and will therefore remain unaffected by hormone therapy. These cannot be allowed to grow unchecked and as a result, hormone therapy often has to be used in combination with another treatment.
Like most treatments, hormone therapy isn’t perfect and it is certainly not a cure all for prostate cancer. But it is an important weapon in the fight against the disease and it usually plays a significant part in every man’s treatment.
There are several different types of hormone therapy. Orchiectomy involves the surgical removal of the testicles. Because about 90% of testosterone is produced by the testicles, removing them is an effective solution. However, because this is such a permanent and irreversible procedure, most men today choose drug therapy instead.
For those who do choose this option, here is what you need to know. This procedure is usually done on an outpatient basis in the urologist’s office. You will recover quickly and no further hormone therapy will be necessary. This makes orchiectomy a low-cost and quick solution.
Another option is to use LHRH agonists. LHRH (luteinizing-hormone releasing hormone, also called GnRH or gonadotropin-releasing hormone) is one of the key hormones released by the body before testosterone is produced. Blocking its release through the use of LHRH agonists or analogues is one of the most common ways of treating men with prostate cancer.
A range of different drugs can be used for this. Leuprolide, goserelin and triptorelin are most frequently used and they are usually given in the form of regular injections. Depending on what your doctor decides, you may be injected once a month, once every three months, once every four months or once a year.
When you are given your LHRH agonists, you may also be given some antiandrogens. This is because LHRH agonists can cause what is known as a flare’ reaction. The presence of LHRH agonists leads to an initial rise in testosterone, which results in a variety of symptoms. These can be painful and irritating and range from bone pain to urinary frequency or difficulty.
Antiandrogens counteract this. Antiandrogens such as bicalutamide, flutamide and nilutamide help to block the action of testosterone in prostate cancer cells. Your doctor will probably add them to the LHRH agonist for at least the first four weeks of hormone therapy, thereby preventing any adverse reaction.
Orchiectomy and the use of LHRH agonists (along with antiandrogens) are all effective in the control of prostate cancer cells. However, there are inevitably going to be side effects. Testosterone is a vital hormone in the male system and its loss brings about changes in nearly all men. From weight gain and decreased muscle mass to memory loss, erectile dysfunction and fatigue; these symptoms can be severe.
Be sure to discuss all changes in your body with your doctor. You should be able to take steps to manage the side effects and improve your quality of life while continuing to fight prostate cancer as best you can.