Page 2 - Hormone Therapy for Prostate Cancer
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Hormone therapy for prostate cancer




        doctor. LHRH agonist treatment and orchiectomy are        fractures. In some cases, this risk can be reduced
        equally effective for prostate cancer control.            with calcium and vitamin D supplements or with the
                                                                  use of additional medications (bisphosphonates).
        Several medications taken by mouth can block              Side effects of the anti-androgen drugs may include
        the effect of androgens without suppressing their         nausea, diarrhea, breast tenderness and liver
        production. These drugs called anti-androgens are         dysfunction.
        usually used in combination with an LHRH agonist
        or orchietomy. They are often used prior to starting      Having both cancer and hormone therapy may
        the LHRH agonist injections to block a short-lived        cause a slight increase in the risk of blood clot
        increase in testosterone production caused by the         formation which could lead to a stroke or heart
        first injection. Once the injections have completely      attack. Your urologist may recommend a small daily
        suppressed the androgens from the testicles, the          dose of aspirin to reduce this risk.
        anti-androgen medications can often be stopped.
        Some physicians continue the anti-androgen with the       Timing of hormone therapy
        LHRH agonist injections for the possibility of improved
        cancer control (total androgen blockade).                 While treatment should be started promptly for any
                                                                  man with symptoms due to prostate cancer (such as
        The effect of hormone therapy is monitored with           disease that has spread into the bones), the timing of
        regular review of health status and testing the           hormone therapy in men without symptoms remains
        PSA level.
                                                                  controversial. Some believe that hormone therapy
                                                                  should be started at the first sign of disease activity
        Side effects of hormone therapy                           (usually a rising PSA) before symptoms develop
                                                                  (early treatment). Others feel that treatment can be
        Male hormones serve several important functions in        delayed for months or even years (deferred treatment)
        the body. Their elimination, by surgery or medication,    without great risk, avoiding side effects of treatment.
        may result in a number of effects. Most men will have     Studies are underway to determine the optimal timing
        hot flashes, much like those experienced by women         of hormone therapy.
        at menopause. The frequency and severity of hot
        flashes are variable, usually decrease over time and,     Although hormone therapy is usually used
        when bothersome, are treatable.                           continuously, some physicians may offer intermittent
                                                                  hormone therapy. This strategy aims to balance
        Androgens are important to maintain sexual drive          cancer control while minimizing treatment side effects.
        and performance. Men on hormone therapy often             An LHRH agonist is given for a specified period (often
        lose interest in sex and have difficulty with erections.   up to one year) until the PSA level and cancer are
        Fortunately, effective treatment is available to restore   maximally suppressed.  Treatment is then stopped to
        erections for those in whom this is important.            allow testosterone production to resume and the side
                                                                  effects of the medication to disappear (which may
        Mild anemia (low red blood cell count) is common          often take months). The cancer can be expected
        with hormone therapy and may contribute to a              to become active slowly over time as indicated by
        slight loss of energy or fatigue. Muscle strength         a rising PSA. The timing to restart the LHRH agonist is
        may decrease. Over time, thinning of the bones            often determined by the level of your PSA. The long
        (osteoporosis) may lead to an increased risk of           term cancer control of this approach compared to
                                                                  continuous treatment is not yet established.


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        practitioner. The Canadian Urological Association disclaims all liability and legal responsibility howsoever caused, including negligence, for the
        information contained in or referenced by this brochure.                                   cua.org            25E-HTPE-01-14
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