What Is Hormone Treatment for Prostate Cancer?
Hormone treatment for prostate cancer is also called androgen deprivation therapy (ADT). The goal of this therapy is to reduce the amount of testosterone in the body or block its effect on cancer cells. When testosterone levels drop, prostate cancer cells become weaker and grow more slowly. Sometimes, they may even shrink.
Doctors use hormone therapy when:
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The cancer has spread outside the prostate
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Cancer comes back after treatment
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Cancer is too risky for immediate surgery or radiation
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It is used along with radiation to increase the success rate
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Hormone therapy does not cure the cancer, but it helps keep it under control for a long time.
How Does Hormone Therapy Work?
Hormone therapy works in two main ways:
1. It lowers the testosterone level in the body.
Some medicines tell the testicles to stop making testosterone. When testosterone becomes very low, prostate cancer cells grow more slowly. In some cases, cancer becomes inactive for months or even years.
2. It blocks testosterone from reaching cancer cells.
Some medicines do not lower testosterone levels, but they stop the hormone from attaching to cancer cells. This way, even if testosterone is present, it cannot “feed” the cancer. Once testosterone is reduced or blocked, cancer cells lose their ability to grow and spread. This slows down the disease and reduces symptoms such as pain, urinary problems, or tiredness. Many men feel better after starting hormone therapy because their cancer becomes less active. However, hormone therapy can also cause side effects because testosterone affects many parts of the body.
Common hormone therapy side effects include:
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Hot flashes.
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Weight gain.
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Loss of muscle strength.
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Low energy.
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Mood changes.
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Reduced sexual desire.
Doctors help manage these side effects through lifestyle changes, exercise, and sometimes additional medications.
What Types of Hormone Therapy Are There?
There are several types of hormone therapy for prostate cancer. Each works in its own way. Doctors choose based on the patient’s age, health, stage of cancer, and goals of treatment.
1. LHRH agonists: These drugs reduce testosterone levels by “turning off” signals that tell the testicles to make testosterone. Initially, testosterone levels increase for a short period, then decline to very low levels. They are given as injections once a month or once every few months.
2. Anti-androgens: These medicines do not lower the amount of testosterone in the body. Instead, they work like a shield. They block testosterone from attaching to prostate cancer cells. When cancer cells cannot “use” testosterone, they grow more slowly. Doctors often give anti-androgens along with LHRH drugs to make the treatment stronger and more effective.
3. Combined androgen blockade: In this method, doctors use two types of medicines at the same time, LHRH drugs and anti-androgens. This double approach gives better control over the cancer. It reduces the cancer’s ability to grow by cutting down testosterone levels and blocking the hormone from working. Many patients respond well to this combination because it hits the cancer from two sides.
4. Orchiectomy (surgical removal of testicles): A small surgery in which the testicles are removed. It may sound overwhelming, but the procedure is quick and straightforward. It is one of the oldest treatments for prostate cancer and works very well because it drops testosterone levels almost immediately. The results are similar to taking hormone-blocking medicines. Some men prefer medicines because they feel less permanent, but surgery remains a strong and effective option.
5. Newer hormone drugs: Some newer medicines, such as Abiraterone or Enzalutamide, are very strong blockers of testosterone’s effect. Doctors use them when cancer becomes resistant to older treatments.
Various ways of beginning hormone replacement therapy:
Hormone therapy may be started in several ways according to the level of cancer and the attending physician’s strategy.
1. Continuous therapy: In continuous therapy, the anticancer hormones are given without any break. The level of the male hormone testosterone will be kept low at all times, and the rate of growth of the cancer cells will be kept slow.
2. Intermittent therapy: This therapy would involve taking hormone therapy with cycles, along with a break in treatment. Taking a break from treatment may cause a slight rise in testosterone levels. This will reduce any adverse effects and improve the patient's life. Once the cancer cells show signs of activation, it is advised to start treatments again.
3. Early vs. late treatment: Some men will begin with early treatment after a diagnosis of metastatic prostate cancer. Other men may only receive treatment for advanced cancer. Researchers are actively working to determine the long-term effectiveness of both possible options.
4. Combined therapy with other treatments: Hormone therapy can also be combined with radiation therapy, chemotherapy, and/or targeted therapy. Combined therapy helps increase the effectiveness of treatment and works faster to remove the cancer.
Conclusion
Hormonal therapy for prostate cancer treatment is an effective mechanism that works by slowing the progression of the disease by reducing or inhibiting the production of testosterone. It helps to manage the condition, relieve associated symptoms, and improve the quality of life. Although it does not cure the disease in men, it provides them with additional time and comfort. Talk to a cancer specialist for more information.
Key Takeaways
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Hormone therapy reduces or blocks testosterone to slow prostate cancer.
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There are many types of hormone treatments, including medicines and surgery.
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Doctors may use continuous, intermittent, or combination therapy.
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Research is improving hormone therapy, making it safer and more effective.
