HORMONE THERAPY

 

From the onset of puberty, prostate cells divide and grow because of the male hormone testosterone, which is produced primarily in the testicles. Prostate cancer depends on male hormones, especially testosterone, to help it grow.  Research has shown that reducing or “withdrawing” these hormones will cause prostate tumours to shrink.  Hormone therapy works by getting rid of the testosterone made in the testicles and blocking its action – thereby starving the prostate cancer of the “food” it needs to grow. If the cancer has spread outside your prostate gland to other parts of your body (metastasized), hormone therapy can be used to slow the growth and reduce the size of your tumour.  While hormone therapy can’t cure the cancer, it can sometimes improve the benefit of local treatment (surgery, radiation).

 

There are three different types of hormone therapy:

 

Orchiectomy

This is surgery to remove both testicles.  It stops 90 – 95% of male hormone production.  This surgery has few complications.

 

Luteinizing Hormone – Releasing Hormone (LH-RH) Agonists

This group of medications eliminate the body’s production of testosterone.  They are injected once a month or once every three months.  When used alone, these drugs stop the normal production of testosterone.  These drugs produce few side effects except for hot flashes, and other menopause-like symptoms. 

 

Antiandrogens

Several types of antiandrogens are available for treating prostate cancer. 

 

The most commonly used antiandrogens bind to prostate cancer cell and prevent androgens from getting into the cell to promote its growth, the do not stop the body from manufacturing testosterone and so some of the side effects of low testosterone can be avoided.  Often, they are used together with CH-RH since they work by a different mechanism.  These drops have there own side effects.  The most common are breast enlargement and nipple tenderness. 

 

Hormone therapy does not cure prostate cancer but it can slow the progression of the disease.  At some point, treatment with hormone therapy may stop working. The cancer cells become resistant and begin to grow again.  This is called hormone resistant or hormone refactory metastatic prostate cancer.  If this happens, hormone therapy may be stopped.

 

OTHER TREATMENT OPTIONS

Chemotherapy

This treatment injects drugs into the veins.  The drugs flow through the blood to all parts of your body to damage and kill cancer cells.  This treatment option may be useful for advanced prostate cancer that has spread to other parts of the body. 

 

Again, side effects can occur when the drugs damage healthy cells at the same time as the cancer cells.  These side effects will go away with time as the body replaces the damaged cells.

 

Cryosurgery

This treatment kills cancer by freezing it.  Complications are usually temporary and restricted to organs around the prostate that may also freeze.  Currently this form of therapy has very limited use.

 

Thermotherapy

This treatment uses microwave technology to heat the prostate to kill cancer cells.  This method is often used to treat men whose cancer has recurred after radiation therapy, but not yet spread outside their prostate.   Currently this therapy is considered experimental in the treatment of prostate cancer.