Prostate Cancer Hormone Therapy
These drugs can block the action of male hormones. Examples include:
Some drugs, such as ketoconazole and aminoglutethimide, can prevent the adrenal gland from making testosterone.
Surgery to remove the testicles is called orchiectomy. Since the testicles are a primary source of testosterone, which prostate cancer cells need to grow, removing them can help keep the cancer from spreading.
After orchiectomy or treatment with an LH-RH agonist, your body no longer gets testosterone from the testicles; however, the adrenal gland still produces a small amount of male hormones. You may receive an antiandrogen to block the action of the male hormones that remain. This combination of treatments is known as total androgen blockade.
Studies have not shown whether total androgen blockade is more effective than surgery or an LH-RH agonist alone.
Doctors can usually control prostate cancer that has spread to other parts of the body with hormone therapy. The cancer often does not grow for several years. However, in time, most prostate cancers can grow with little or no male hormones. Then hormone therapy is no longer helpful. At that time, your doctor may suggest other forms of prostate cancer treatment that are under study.
Prostate cancer hormone therapy is likely to affect your quality of life. It often causes side effects such as:
An LH-RH agonist may make your symptoms worse for a short time when you first take it. This temporary problem is called "flare." The treatment gradually causes your testosterone level to fall. Without testosterone, tumor growth slows. Your condition may improve. To prevent flares, your doctor may give you an antiandrogen for a while along with the LH-RH agonist.
Antiandrogens such as nilutamide used as part of hormone therapy for prostate cancer can cause:
- Breast growth or tenderness.
In rare cases, they may cause liver problems (pain in the abdomen, yellow eyes, or dark urine). Some men who use nilutamide may have difficulty breathing; others may have trouble adjusting to sudden changes in light.
If used for a long time, ketoconazole may cause liver problems, and aminoglutethimide can cause skin rashes. If you receive total androgen blockade, you may have more side effects than if you have just one type of prostate cancer hormone therapy.
Any treatment that lowers hormone levels can weaken your bones (a condition called osteoporosis). Your doctor can suggest medicines or dietary supplements that may reduce your risk of this condition.