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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