If you have advanced prostate cancer at the time of your diagnosis, or if your prostate-specific antigen (PSA) levels are rising despite having had other treatment for prostate cancer in the past, your doctor may suggest hormone therapy. Hormone therapy may also be used after you have completed other treatments, such as radiation to the prostate gland, to decrease the risk of your cancer returning.
When used alone, hormone therapy does not cure prostate cancer, but it does stop it from progressing for a period of time. Typically, you can expect hormone therapy to control your prostate cancer for at least one to four years and possibly for as long as 10 years or more. Eventually, however, the prostate cancer cells adjust to the lack of hormones and will begin to grow again without them.
The advantages of hormone therapy include halting the growth of your cancer and avoiding surgery or radiation therapy. Side effects include impotence, hot flashes and mood swings.
How It Works
Male hormones, including testosterone, stimulate the growth of prostate cancer cells. Hormone therapy, which is also called endocrine therapy, interferes with the ability of testosterone or other testosterone-like hormones to bind to receptors on prostate cancer. Some types of hormone therapy turn off your body’s ability to make testosterone. Other types keep the testosterone from getting to the prostate cancer. Without these hormones, the growth of your prostate cancer is stopped or delayed.
The most common form of hormone therapy is given as an injection. Typically you will receive a shot every one, three or four months, depending on the dose. Your doctor will monitor your PSA levels with frequent blood tests to make sure that the hormone therapy is working.
Other, less common types of hormone therapy include surgery to remove the testes; “antiandrogens,” drugs that block the receptor for testosterone on the prostate cancer; or estrogen therapy, which is given in pill form or as a skin patch rather than as an injection.
Hormone therapy is effective in about 85 to 90 percent of the men who opt for this treatment. Although it is typically used to treat advanced prostate cancer, it may also be used in men with curable prostate cancers to shrink the prostate before surgery or radiation therapy and to decrease the risk of prostate cancer coming back after radiation.
Side Effects of Hormone Therapy
Any man considering hormone therapy will want to weigh the risks and benefits of the treatment. Side effects include impotence, hot flashes, osteoporosis, weight gain and mood swings. Occasionally men will develop swelling of the breasts.
You will probably find that hormone therapy lowers your sex drive, and it may interfere with your ability to have an erection. Once the hormone therapy is completed, this problem usually goes away.
Almost all men receiving hormone therapy experience hot flashes, just as women do when they are going through menopause. If hot flashes are a problem for you, ask your doctor about medications or alternative-medicine approaches to help alleviate them.
Hormone therapy lowers the level of both testosterone and estrogen, which maintains bone strength. Men who receive hormone therapy for prolonged periods may develop thinning of the bones. Your doctor may follow the density of your bones during hormone therapy and, if appropriate, prescribe medications to prevent complications from osteoporosis.
Hormone therapy can decrease muscle mass and increase the percentage of body fat, increasing body weight overall. Talk with your doctor about how to modify your diet and ask whether exercise is appropriate to prevent these complications.
Hormone therapy causes mood swings and irritability. These should lessen with time, but if you feel your mood swings are too severe, talk to your doctor about antidepressants or other medications that can help.
Hormone therapy may cause enlargement of the breasts (gynecomastia) and breast pain. These problems are more common with the use of estrogens as hormone therapy. Talk with your doctor about ways to prevent this problem.