Hormone therapy for prostate cancer: What you need to know

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

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:

Orchiectomy

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.

Luteinizing hormone-releasing hormone (LHRH) agonists

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:

• leuprolide (Eligard)
• triptorelin (Trelstar)
• goserelin (Zoladex)

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.

Some examples of these include:

• degarelix (Firmagon)
• relugolix (Orgovyx)

Second-generation hormone therapy

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:

• bicalutamide (Casodex)
• flutamide (Eulexin)
• cyproterone acetate

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.

If you need help covering the cost of medications, Optum Perks’ free Discount Card could help you get up to 80% off prescription medication. See how much you can save on your medication here.

What are the side effects?

Side effects with hormone therapy are common because of the low levels of testosterone in the body. Some examples include:

• erectile dysfunction or loss of sexual desire
• hot flashes
• anemia
• bone thinning (osteoporosis)
• weight gain
• fatigue or depression

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.

Download the free Optum Perks Discount Card to save up to 80% on some prescription medications.