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What is hormone therapy for prostate cancer?
- Anna(AI First Responder)••Verified by Curio clinician
Hormone therapy, also known as androgen deprivation therapy (ADT), is a common treatment for prostate cancer. Prostate cancer cells rely on male hormones called androgens, such as testosterone, to grow and multiply. Hormone therapy works by reducing the levels of these hormones in the body or by blocking their effects on cancer cells.
There are different types of hormone therapy for prostate cancer, including:
Medications: The most common approach is to use medications that either stop the production of androgens in the testicles or block their action. These medications are usually given as injections or taken orally. Examples include luteinizing hormone-releasing hormone (LHRH) agonists, LHRH antagonists, and anti-androgens.
Surgical removal of the testicles: This procedure, called orchiectomy, permanently stops the production of testosterone. It is a simple surgical procedure that can be done under local or general anesthesia.
Hormone therapy is often used in combination with other treatments for prostate cancer, such as radiation therapy or surgery. It can be used before these treatments to shrink the tumor and make it easier to remove or target with radiation. Hormone therapy may also be used after other treatments to prevent the cancer from coming back or to control its growth.
It's important to note that hormone therapy is not a cure for prostate cancer. Over time, some prostate cancer cells may become resistant to hormone therapy, leading to disease progression. However, hormone therapy can be effective in controlling the growth and spread of prostate cancer for many years in most cases.
If you or someone you know is considering hormone therapy for prostate cancer, it is important to consult with a healthcare provider who specializes in cancer treatment. They can provide personalized information and guidance based on the specific situation.
- Hillary Lin(Physician)•
Here are some specific types of medications oncologists might recommend for prostate cancer:
- Luteinizing hormone-releasing hormone (LHRH) agonists: These drugs reduce the amount of testosterone made by the testicles. Examples include:
Leuprolide (Lupron, Eligard) Goserelin (Zoladex) Triptorelin (Trelstar) Histrelin (Vantas, Supprelin LA)
- Luteinizing hormone-releasing hormone (LHRH) antagonists: These drugs also lower testosterone levels but work differently from LHRH agonists. An example is:
- Anti-androgens: These medications block the action of androgens. They are often used in combination with LHRH agonists or before starting LHRH agonists to prevent a flare-up in symptoms. Common anti-androgens include:
Bicalutamide (Casodex) Flutamide (Eulexin) Nilutamide (Nilandron) Enzalutamide (Xtandi)
- CYP17 inhibitors: These drugs block an enzyme (CYP17) that helps the body produce androgens. An example is:
Abiraterone acetate (Zytiga)
As mentioned in the other post, orchiectomy or the removal of the testicles might also be done to help with removing the body's usual source of testosterone. This is permanent androgen deprivation.
There are additional medications that might get added to hormone therapy to improve its results: Ketoconazole, which can block the production of steroids, including testosterone. Estrogens, although they are rarely used today because of their cardiovascular side effects.
Your oncologist might choose to do Intermittent Androgen Deprivation (IAD): This involves cycles of hormone therapy treatments followed by breaks. The idea is to give men a break from the side effects of continuous hormone therapy.
In addition, your doctor might recommend Combined Androgen Blockade (CAB): This approach uses both an LHRH agonist (or LHRH antagonist) and an anti-androgen. Some studies have suggested that combined therapy might be slightly more effective than just one form of hormone therapy, but with increased side effects.
Side Effects of Hormone Therapy: Common side effects of hormone therapy for prostate cancer include hot flashes, reduced sexual desire, impotence, fatigue, loss of muscle mass, weight gain, osteoporosis, mood swings, and an increased risk of cardiovascular events. It's essential to discuss potential side effects with the healthcare provider to understand and manage them.
It's important to remember that while hormone therapy can effectively control prostate cancer, particularly advanced or metastatic cases, it's not a cure. Over time, the cancer can evolve to become castration-resistant, which means it grows despite low testosterone levels. In such cases, other treatments may be needed.
Hope this is helpful!