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Hormonal Therapy

All prostate cells are stimulated by the male hormone testosterone. The testicles produce 95% of a man's testosterone. The job of testosterone is to regulate the normal function, growth and development of the male reproduction organs, including the prostate gland. However when prostate cancer develops, testosterone can make the cancer grow much faster.

By either removing the testicles, or by interfering with the action of testosterone in different ways, the cancer is starved and it shrinks.

There are different ways to do this:

Surgical castration is an operation to remove the testicles (or remove just the parts of the testicles which produce testosterone). The procedure is called orchiectomy or orchidectomy.
LHRH agonist injections stop the testicles making testosterone. LHRH stands for "luteinizing hormone-releasing hormone" or LHRH analogs. This drug is usually given by injection once a month or every three months. The therapy spares the testicles and works just as well as surgical castration.
Anti-androgen tablets block the effect of testosterone in the body.
Complete androgen blockade Sometimes tablets and injections are used together and this is known as complete androgen blockade (CAB) or maximal androgen blockade (MAB).

When is Hormone Therapy Used?
If the cancer has spread outside the prostate gland to other parts of the body, physicians normally use hormonal deprivation therapy to slow the spread or growth of the cancer.

Hormone therapy may also be used to shrink the size of the prostate gland before you receive another kind of treatment (such as radiotherapy or brachytherapy).

Men whose cancer has returned after radical prostatectomy or radiation therapy may be offered hormonal therapy.

Deciding the best treatment for prostate cancer is a challenge.
No single treatment or combination of treatments is right for everyone.

Click here for more information about the minimally invasive procedure, brachytherapy

Effectiveness of Hormonal Therapy
Gradually, hormonal therapy causes the male hormone level to fall and tumor growth to slow. A drop in hormone levels can affect all prostate cancer cells, even those that have spread to other parts of the body, and the treatment can control prostate cancer for up to several years.

However, some prostate cancers can grow with little or no male hormone. Other prostate cancer cells may develop resistance and learn to grow without the hormone. If this happens your doctor may suggest other forms of treatment.

If surgical castration is performed, the adrenal glands compensate for the removal of the testicles by producing more male hormone, so even after having his testicles removed, a man will have to take drugs to block the flow of male hormone.

Recovery Time After Hormonal Therapy
Surgical castration is a relatively simple procedure. The patient usually receives a local anesthetic and goes home the day of the surgery.

Risks and Side Effects of Hormonal Therapy
All forms of hormone therapy have roughly similar side effects but every man reacts in a different way - some get a lot of side effects, some get very few.
All types of hormonal therapy may cause side effects generally known as the "Male Hormonal Withdrawal Syndrome." This syndrome may include symptoms like:

Impotence
Loss of sexual desire
Hot flashes
Weight gain
Tiredness
Loss of muscle mass

Other Potential Problems:
Surgical castration is not reversible. In some cases it may require a stay in hospital.

LHRH agonists may tend to increase tumor growth at first and make the patient's symptoms worse. This problem is called "tumor flare."

Androgen blockade treatment may cause patients to have nausea, vomiting or tenderness and swelling of their breast tissue.

Osteoporosis



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