Male hormones, or androgens, can act as the fuel for prostate cancer growth. The testicles are a man’s main source of the male hormone testosterone. The adrenal gland makes other male hormones and a small amount of testosterone. One way to slow the growth of the cancer cells is to reduce the amount of male hormones present in the body.
There are two different methods for reducing male hormones.
Drug Therapy: this is the most common form of hormone therapy for prostate cancer. These drugs block natural hormones from producing, slowing the growth of the cancer:
Luteinizing hormone-releasing hormone (LH-RH) agonists: These drugs can prevent the testicles from making testosterone. Examples are leuprolide, goserelin, and triptorelin. The testosterone level falls slowly. Without testosterone, the tumor shrinks, or its growth slows. These drugs are also called gonadotropin-releasing hormone (GnRH) agonists.
Antiandrogens: These drugs can block the action of male hormones. Examples are flutamide, bicalutamide, and nilutamide.
Other drugs: Some drugs can prevent the adrenal gland from making testosterone. Examples are ketoconazole and aminoglutethimide.
Surgery: Surgery to remove the testicles is called orchiectomy. Without the testicles most of the male hormones produced in the body can no longer be made.
If you have early stage cancer, and your oncologist feels there is an intermediate or high risk of the prostate cancer recurring, hormone therapy may be recommended. It can be given before, during and/or after radiation therapy or after prostatectomy. RCOG’s database of patient outcomes, including tens of thousands of cases, indicates that there is not a higher cure rate for prostate cancer when using hormone therapy before ProstRcision.
Oncologists are more likely to treat prostate cancer that has spread to other parts of the body with hormone therapy. For some men, the cancer will be controlled for two or three years, but others will have a much shorter response to hormone therapy.
Hormones can cause some complications. Almost all men get hot flashes, similar to a woman going through menopause, which can last for a year or more with just one hormone shot.
Virtually all sexually active men will lose sexual function. If given over a long period of time, hormones can also cause thinning of the bones (osteoporosis), which increases your chance of breaking a bone. Additional complications are weight gain, muscle weakness, and overall loss of energy, increased problems with thought process (making decisions or thinking clearly), as well as an increased chance of diabetes and heart attacks.
Men with advanced prostate cancer benefit from a combination of hormones and external beam irradiation compared to beam radiation only. In contrast, medical studies of seed implantation plus hormones show no benefit to men. It’s important to discuss how your prostate cancer treatment involving hormones can impact your overall health.