Prostate cancer is a common form of cancer in men. One possible treatment for it is hormone therapy. There are many benefits, but also some possible side effects.
Prostate cancer is a form of cancer commonly diagnosed in men. It affects the prostate gland, which is regulated by a hormone called testosterone. However, testosterone can also help prostate cancer cells to grow.
Because of testosterone’s role, hormone therapy can be useful in treating prostate cancer. This treatment reduces the level of male hormones, called androgens, in the body. It is usually combined with other forms of treatment, like surgery, chemotherapy, and radiation therapy.
According to the Centers for Disease Control and Prevention (CDC), prostate cancer can affect any man, and it is the second most common form of cancer in men in the United States after non-melanoma skin cancer. Hormone therapy can help you manage the condition.
Hormone therapy options
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Hormone therapy, also known as androgen deprivation therapy, is used to stop androgens from working or to stop them from being produced. It doesn’t cure the cancer entirely but can control the symptoms and slow the growth. Most prostate cancer cells stop growing once the body stops producing testosterone.
There are several different types of hormone therapy that prevent testosterone from being produced:
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Orchiectomy, or surgical castration, is where the testicles are removed entirely to stop the production of the hormones. The testicles are where most androgens are produced, so this effectively lowers the androgen levels and can stop the growth or spread of prostate cancers. However, it is permanent.
These are medications that lower the levels of testosterone that the testicles produce. They’re injected or implanted beneath the skin. Some kinds of LHRH agonists include:
These are given by a healthcare professional every 4 weeks, 3 months, or 6 months, depending on the kind. They may cause a temporary increase in testosterone levels, known as a flare. This may worsen symptoms, like pain, for a short time.
Unlike in orchiectomy, the testicles aren’t removed with this option, but they may shrink. One 2018 study with 58 men found that LHRH agonists reduced testosterone levels significantly more than orchiectomy did.
LHRH antagonists
These also lower testosterone levels, but they do so more quickly than LHRH agonists and don’t cause a flare. This may avoid making the symptoms worse.
This is used either alone or in combination with other hormone therapies. Some studies have shown that it improves survival in people with prostate cancer. Examples of medications include:
abiraterone (Zytiga)
enzalutamide (Xtandi)
Anti-androgens
Anti-androgens block testosterone from attaching to the prostate cancer cells. A healthcare professional usually prescribes them before you start taking LHRH agonists, or you take them alongside them.
Anti-androgens are taken as pills, and they stop testosterone from reaching the cancer cells. Some examples of these include:
They have been found to improve the effects of other hormone therapies when used together. A 2017 study found that anti-androgen therapy combined with radiation therapy increased survival rates in patients with prostate cancer that came back after surgery.
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These side effects can be managed by treating them individually. For example, hot flashes and depression may be treated with antidepressants. People who experience bone thinning can take medications like alendronate and zoledronic acid to ease this side effect. Increasing iron consumption can help manage anemia.
The side effects of anti-androgens are similar to those of the other treatment options (for example, bone thinning and hot flashes). However, you’re less likely to experience sexual disruption if you take anti-androgens alone. When taken in combination with LHRH agonists, you might experience diarrhea.
Summary
Hormone therapy can help treat prostate cancer by blocking testosterone production. It is often combined with other treatment methods like surgery, chemotherapy, and radiation therapy, or it’s used when these other options don’t work.
There are several different forms of hormone therapy, so speaking with a healthcare professional may help you decide what’s right for you.
Hormone therapy has a range of possible side effects, but you can manage these with other medications. Consider speaking with a healthcare professional if you have concerns about side effects.
Østergren PB, et al. (2018). Luteinizing hormone-releasing hormone agonists are superior to subcapsular orchiectomy in lowering testosterone levels of men with prostate cancer: Results from a randomized clinical trial. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5433917/
Swami U, et al. (2021). Treatment pattern and outcomes with systemic therapy in men with metastatic prostate cancer in the real-world patients in the United States. https://www.mdpi.com/2072-6694/13/19/4951
