How to manage prostate cancer hormone therapy side effects?

Question

Hello doctor,

My father is 75 years old and was recently diagnosed with prostate cancer. My father’s doctor suggested hormone therapy as one of the options for treating him. But then I came across some sources saying that hormone therapy might lead to thinning of bones, muscle wasting, and tiredness.

Is there anything that can help to alleviate these side effects?
Any other treatments available?

Please help.

Answer 1

Hello,

Welcome to icliniq.com

I have read your query and understand your concern.

Hormone therapy, otherwise known as androgen deprivation therapy (ADT), is one common treatment of choice for prostate cancer, especially among the elderly and when the prostate cancer is advanced, recurrent, or higher risk cancer.

Androgen deprivation therapy may indeed result in side effects such as:

Bone thinning or osteoporosis
Muscle wastage and weakness
Fatigue
Weight gain
Hot flashes
Changes in metabolism leading to alterations in blood sugar and cholesterol levels.

There are some ways to minimize or even manage the above-mentioned side effects, such as:

Monitoring bone density using DEXA (Dual-energy X-ray absorptiometry).
Ingestion of adequate amounts of Calcium and Vitamin D.
Administration of bisphosphonates (Zoledronic acid, Alendronate) or Denosumab in case of bone thinning.
Weight-bearing activities like walking and mild weight lifting.

For muscle strength and energy maintenance, you should:

Regular physical activity and resistance exercises can be very beneficial.
A balanced, protein-rich diet may help preserve muscle mass.
Monitoring cardiovascular and metabolic health is also important during treatment.

The possibility of alternative treatments depends mainly on the stage, aggressiveness, PSA (prostate-specific antigen) level, Gleason score, and overall health of the patient.

In some situations, alternatives or modifications may include:

Active surveillance for low-risk disease.
Radiation therapy.
Surgery in selected patients.
Intermittent hormone therapy in certain cases to reduce long-term side effects.

Questions you can ask the doctor.

Is his cancer high-risk, intermediate-risk, or low-risk?
Can we consider intermittent ADT instead of continuous?
Has his bone health been assessed yet?

However, for many patients, hormone therapy remains an important part of controlling prostate cancer progression and improving outcomes.

It is very reasonable to discuss side-effect prevention and quality-of-life concerns with his treating oncologist before and during treatment so that supportive measures can be started early.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.