HORMONE TREATMENT FOR PROSTATE CANCER

Metastasized prostate cancer is generally treated via hormone therapy. (Metatasis is when the cancer has spread elsewhere, typically to the lymph nodes, bones, lungs, or liver. Once metatisized, the disease cannot be cured by surgery or radiation. It is a physical impossibility since the cancer cells cannot all be removed or radiated. Hormone therapy treats the entire body, including cancer cells too small to be detected. It is also used when the patient is deemed unable to withstand surgery.

Note: When faced with hormone therapy, many men seek alternatives including natural supplementation. 

The concept of hormone treatment is this.  Interfere with the production of male hormones or else block the hormones actions that stimulate prostate tumor growth.

Hormone therapy often shrinks the cancer size. These patients can then expect to keep the cancer under control for many years.

Remember, hormonal therapy is not a cure for prostate cancer.  It's goal is to slow the spread of hormone- dependant prostate cancer cells.

3 Primary types of hormonal treatment:

• Surgical removal of the testicles (stop testosterone production)
• Antiandrogen therapy to block the effects of androgens (testosterone is one)
• Luteinizing Hormone-Releasing Hormone (LH-RH) Agonists

1. Orchiectomy

Orchiectomy used to be called Orchidectomy.  It is the surgical removal of the testicles, or medical castration. This may be the simpliest way to change the hormones (androgens).  Since testosterone is produced in the testes, obviously its production is impacted.  This drastic treatment (in the opinion of many men) produces side effects that include hot flashes, breast tenderness and growth, impotence and a loss of sexual desire, and depression.

Reconstructive surgery may be accomplished.  Silicone implants closely resemble the actual organs.

Before this operation is carried out your urologist may require more tests to verify the diagnosis.

2. Antiandrogen therapy

Testosterone is an androgen. Antiandrogens block the production testosterone, so the growth of the testosterone dependant cancer is inhibited. Often this treatment is prescribed intermittently with breaks in between sessions.

Antiandrogen therapy does not eliminate testosterone so may have fewer or less severe side effects than either surgery or medical castration.

Strangely a man's body demonstrates an "anti-androgen withdrawal effect." In simple English this means the patient benefits from withdrawing the treatment. 

The most common antiandrogen drugs used for prostate cancer hormone therapy:

• Flutamide
• Bicalutamide
• Nilutamide

These are oral tablets.  They should be taken at the same time each day to combat nausea. Diarrhea is a frequent side effect, although queasiness, liver problems, and fatigue can occur in a few patients.

The major difference from taking LHRH agonists is antiandrogens have fewer sexual side effects.  This is a desirable trait for men who still have an active sex life. When these drugs are used alone, libido and potency are normally unaffected.

Peoples response vary, but side effects are generally not too serious. If there are more serious side effects always discuss the matter with your doctor.  

3. Luteinizing Hormone-Releasing Hormone (LHRH) Agonists

These drugs are especially formulated to ease the symptoms of advanced prostate cancer. They do not cure prostate cancer but in certain cases they can reduce the testosterone produced by the testicles as efficiently as an Orchiectomy. (Surgical removal of the testicles).

Doctors do not use it as often as surgery because of the drug expense (HMOs) and the treatment requires more medical supervision.

Lupron Depot (leuprolide acetate for depot suspension) is an LHRH agonist used for symptoms from advanced prostate cancer. Lupron Depot stops the tumor from feeding on the testosterone thus slowing the advance of the cancer.

Do discuss this treatment intelligently with your doctor.  Some disturbing information can be found on the government medical website, PubMed

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