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How to manage the side effects of hormone therapy?

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician.

Patient's Query

Hello doctor,

My prostate biopsy shows Gleason 4+5=9 in 6 of 12 cores. A bone scan shows three suspicious areas in my spine. PSA is 22.4 ng/mL. The urologist is recommending immediate hormone therapy and possibly chemotherapy. I am relatively young and worried about my quality of life on hormone therapy. What are my options for managing side effects? Should I get genetic testing?

Kindly advice.

Answered by Dr. Nawrin Hossain

Education:

MBBS

Professional Bio:

Dr. Nawrin Hossain is a skilled General Physician with five years of experience in the medical field. Committed to providing compassionate care, she specializes in diagnosing and treating a wide range of health conditions, ensuring optimal patient outcomes with a focus on holistic well-being.

This doctor is not available for online consultations on the platform anymore.

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

You have been diagnosed with high-risk prostate cancer, and those suspicious areas of the spine indicate metastasis. In this scenario, hormone therapy is the standard treatment plan.

Hormone therapy may show some side effects, and you can manage them. For example:

1. Hot flashes: wear comfortable clothes, and avoid spicy food and caffeine. A low dose of Venlafaxine or Gabapentin can also help.

2. Decreased bone health: Take calcium and vitamin D supplements for bone health. Add Denosumab to increase bone density.

3. Muscle loss and weight gain: Regular exercise and a high-protein diet can minimize muscle loss.

4. Fatigue: regular exercise, proper sleep, and vitamin supplements can help with it.

5. Mood and cognitive changes: Seek counseling and take antidepressants.

6. Cardiovascular risks: Monitor cholesterol, blood sugar, and blood pressure regularly. Eat healthy and exercise regularly.

Chemotherapy can cause weakness, loss of appetite, nausea, and vomiting. You can get symptomatic treatment for that. Genetic testing is strongly recommended for identifying hereditary cancer syndromes, for example, BRCA (breast cancer genes) mutations or Lynch syndrome.

I hope this helps.

Kindly follow up if you have more concerns.

Thank you.

Medically reviewed by iCliniq medical review team
Published At February 3, 2025
Reviewed At September 30, 2025

Education:

MBBS

Professional Bio:

Dr. Nawrin Hossain is a skilled General Physician with five years of experience in the medical field. Committed to providing compassionate care, she specializes in diagnosing and treating a wide range of health conditions, ensuring optimal patient outcomes with a focus on holistic well-being.

This doctor is not available for online consultations on the platform anymore.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Education:

MBBS

Professional Bio:

Dr. Nawrin Hossain is a skilled General Physician with five years of experience in the medical field. Committed to providing compassionate care, she specializes in diagnosing and treating a wide range of health conditions, ensuring optimal patient outcomes with a focus on holistic well-being.

This doctor is not available for online consultations on the platform anymore.

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