What is hormone therapy for Prostate Cancer
In prostate cancer, hormone therapy works by preventing the production of testosterone (which is precisely a male hormone) or by preventing it from reaching the cancer cells. This is because, in most cases of this disease, abnormal cells depend on testosterone to multiply. The use of hormonal therapy causes these cells to die or grow more slowly.
Male hormonal therapy is also known as androgen deprivation therapy or hormonal blockade.
Its main indications are:
- In advanced (metastatic) prostate cancer, to reduce the size and growth of the tumor;
- After prostate cancer treatment, when the PSA (prostate-specific antigen) level remains elevated or is rising;
- In locally advanced prostate cancer, as an adjunct to external beam radiotherapy, to make the treatment more effective and have a lower risk of recurrence; and
- In those with a high probability of recurrence, as an attempt to reduce this risk.
Types of hormone therapy in prostate cancer
There are different ways to prevent the production of testosterone in patients with prostate cancer. The most important ones are:
- LHRH agonists and antagonists – these are medications used to stop the production of testosterone by the body, a process known as chemical castration. They are injected under the skin or into the muscle once a month, every three or six months. Alternatively, they can be administered through an implant placed under the skin that slowly releases the medication over an extended period of time;
- Antiandrogen therapy – antiandrogens prevent testosterone from reaching the cancer cells. They are oral medications usually prescribed before or simultaneously with the use of LHRH agonists;
- Other androgen-blocking drugs – when prostate cancer is resistant to treatment or recurs, other medications, such as corticosteroids, may be used to block testosterone in the body; and
- Orchiectomy – this is the surgical procedure for the removal of the testicles, also known as surgical castration.
Possible adverse effects and complications of hormonal therapy in prostate cancer
Hormonal therapy can trigger adverse effects in prostate cancer, varying in type and intensity among patients. The most commonly observed are:
- Hot flashes;
- Decreased libido or loss of sexual capacity (erectile dysfunction);
- Bone weakening;
- Diarrhea;
- Nausea;
- Increased breast size and sensitivity;
- Fatigue;
- Weight gain;
- Muscle loss;
- Increased cholesterol;
- Depression; and
- Reduced mental agility.
