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Prostate cancer is one of the most common cancers in men, especially in men over the age of 50. Hormone therapy, sometimes also called anti-hormone therapy or androgen deprivation therapy (ADT), is a possible treatment for prostate cancer. While it does not cure cancer, the treatment can significantly improve and enhance the quality of life. It may also help to improve the survival rate of men with advanced or recurrent prostate cancer. However, it is important to understand how hormone therapy works and what to expect to determine if it is the right treatment for you.
If you've been diagnosed with prostate cancer and need guidance, our prostate cancer specialists are here to help you understand your options and start the right treatment, including hormone therapy. Book your consultation today!
Hormone therapy is one of the treatment options for prostate cancer. Androgens occur naturally in the body and control the growth and activity of normal cells. An increase in the levels of androgen can lead to the growth of prostate cancer. Testosterone and dihydrotestosterone (DHT) are the primary androgens in the body. Lowering their levels or preventing them from reaching prostate cancer cells can help shrink the cancer or slow its progression.
Hormone therapy may be a treatment option if:
● The cancer has spread beyond the prostate
● The patient is not fit for surgery or radiation therapy
● Cancer is recurring after treatment
● Done alongside radiation to improve outcomes
The exact cause of prostate cancer is not clear, but there are some factors that can raise the risk of this cancer. These include:
● Age: The risk increases as you get older, especially after 50 years.
● Family History: Men who have a family history of prostate cancer are more likely to develop it themselves.
● Genetic Mutations: Certain abnormalities of the genes, such as BRCA1, BRCA2, or HOXB13, can raise the risk of prostate cancer.
● Obesity: Obese men are at greater risk of developing aggressive or advanced-stage prostate cancer.
● Hormonal Imbalance: High levels of androgens may promote prostate cancer cell growth.
Early-stage prostate cancer usually does not cause symptoms. As the cancer progresses, it may show the following symptoms:
● Frequent urination
● Urgency in urination
● Weak urine flow
● Pain or burning during urination (dysuria)
● Accidents due to loss of bladder control (urinary incontinence)
● Loss of bowel control (fecal incontinence)
● Painful ejaculation and erectile dysfunction (ED)
● Blood in semen (hematospermia) or urine
● Pain in your low back, hip, or chest
Screening tests help with the diagnosis of prostate cancer. They may include:
● Digital rectal exam: The doctor inserts a gloved, lubricated finger into your rectum and checks your prostate gland for any bumps or hard areas.
● Prostate-specific antigen (PSA) blood test: The prostate gland makes a protein called prostate-specific antigen (PSA). High PSA levels may indicate cancer. This blood test helps to measure the levels of PSA.
● Imaging Tests: An MRI or a transrectal ultrasound can show images of your prostate gland, including abnormal areas that may be cancer. Imaging results can help the doctor decide whether a biopsy is required.
● Biopsy: A tissue sample is removed and then tested in the lab for cancer. A biopsy is the only sure way to diagnose prostate cancer or know its stage.
● Gleason score and grade group: The cancer cells from the biopsy are analyzed to determine if the cancer is growing quickly or slowly.
Hormone therapy is highly effective in slowing the growth of prostate cancer, especially in advanced or recurrent cases. While it doesn’t cure the cancer, it can keep it under control for a long time, sometimes for several years. It's often done in combination with other treatments such as radiation, to boost effectiveness.
Types of hormone therapy for prostate cancer includes:
● LHRH Agonists and Antagonists: These medicines reduce testosterone levels by signaling the brain to stop the testes. They may be given as injections at regular intervals or may be implanted under the skin.
● Anti-androgens: These are given as oral pills and help to block testosterone from acting on the cancer cells.
● Orchiectomy: It is a rarely used surgical method to remove the testicles.
Like any treatment, hormone therapy can cause certain side effects. While some men may experience fewer side effects, others may experience more. This doesn’t mean that the treatment is any less effective.
It’s important to understand that the side effects of hormone therapy are caused by lowered testosterone levels. Side effects will usually last for as long as you are on hormone therapy. If you stop your hormone therapy, your testosterone levels will gradually rise again and some side effects will reduce.
While prostate cancer can't always be prevented, certain steps can help to reduce the risk:
● Get regular prostate screenings especially after the age of 50.
● Maintain a healthy weight.
● Exercise regularly,150 minutes of moderate-intensity exercise every week can be helpful in maintaining overall health.
● Eating a nutritious diet rich in fruits, vegetables and whole grains and avoiding red meats and processed foods can improve overall health.
● Quit smoking, avoid tobacco products and avoid excessive drinking
Hormone therapy for prostate cancer is highly effective. While it may not cure the disease, it plays a crucial role in improving life expectancy and managing symptoms. With newer drugs and better side effect management strategies, patients have more options that can help with better outcomes.
Q: Can I stop hormone therapy once my PSA goes down?
Ans: In some cases "intermittent therapy" may be suggested, where treatment is paused and restarted as needed based on PSA levels.
Q: What is the difference between hormone therapy and chemotherapy in prostate cancer?
Ans: Hormone therapy lowers or blocks male hormones (androgens) to slow cancer growth, while chemotherapy uses medicines to kill the fast-growing cancer cells. Hormone therapy is often less harsh.
Q: How long can you stay on hormone therapy for prostate cancer?
Ans: The duration of treatment depends on the stage of cancer and how well the body responds to the treatment. Some men stay on therapy for months while some may need therapy for several years.