Prostate cancer is the most common form of cancer among men, especially in the United States. It is a hormonally driven solid malignancy. To treat prostate cancer, hormonal therapy has been used for decades. The therapy is known as Androgen Deprivation Therapy that works by lowering testosterone levels. Keep on reading to have a better understanding of Hormone-Sensitive Prostate Cancer, its therapy, and side effects associated with the therapy.
What Is Hormone-Sensitive Prostate Cancer
Hormone-sensitive prostate cancer is a prostate cancer that is hormone dependent. It depends on androgens such as testosterone for it to grow and survive. The hormones act like fertilizers on cancer cells. Therefore, by reducing the level of hormones, cancer goes into shock and some of in the process cancerous dies.
How Hormones Stimulate the Growth of Prostate Cancer
Androgens, male sex hormones, are a class of hormones that control the development and maintenance of male characteristics. The most abundant male sex hormones are testosterone and dihydrotestosterone (DHT). Almost all testosterone is produced in the testicles and a small amount in the adrenal glands. They are required for the normal growth and function of the prostate gland that helps make semen. They contribute to the growth of both normal and cancerous prostate cells by activating the androgen receptors, which stimulate the expression of specific genes. Prostate cancers require high levels of androgens to stimulate their growth.
How effective is Hormone Therapy for Prostate Cancer?
Hormone therapy has long been an integral part of prostate cancer treatment. It is also known as androgen suppression or deprivation therapy. To understand the effectiveness of hormone therapy in treating prostate cancer it is important to first understand how it works and the different types of hormone therapy.
How does Hormone Therapy Work?
Hormone therapy for prostate cancer works by either blocking the effects of androgens or by preventing the body from making them. Either way, the level of androgen hormones is reduced. This, in turn, slows down the growth of cancer. Here are the main types of hormone therapy used to treat hormone-sensitive prostate cancer:
Luteinizing hormone-releasing hormone agonists (LHRH agonists)
These are chemicals that are used to inhibit the production of testosterone in the testicles. They are injected every one to four months. Its effect is reversible when you stop taking the medication.
It is the surgical removal of testicles that produce the testosterone hormones. It was the earliest form of hormone therapy. However, it is permanent and its side effects can be severe. Though, it can be the right choice in some cases.
Unlike orchiectomy and LHRH agonists, anti-androgens affect androgens produced by the adrenal glands. They work by hindering their effect on cancer cells other than stopping their production. This therapy has fewer side effects.
Combined androgen blockade
This therapy combines both anti-androgens and LHRH agonists or orchiectomy. This affects the androgens produced by both the testicles and adrenal glands making it more effective. However, this method increases the manifestation of the side effects.
Synthetic forms of female hormones are produced to treat prostate cancer. However, due to their serious cardiovascular side effects, they are not used often.
The effectiveness of hormone therapy
Hormone therapy helps to shrink the malignant tumor in 85% to 90% of hormone-sensitive prostate cancer cases. Since it works by reducing the level of androgen hormones, the problem is that not all cancer cells depend on hormones to grow. Over time, the cells that are independent of the hormones will spread. If this happens then, hormone therapy won’t help anymore.
Also, prostate cancer might gain resistant to hormone therapy over time. This is because cancer finds a way of converting other hormones or even cholesterol in the blood to make testosterone within it. This makes hormone therapy ineffective. There is ongoing research focused on ways to prevent the resistance.
How long does it take for Hormone Therapy for Prostate Cancer to Work?
Typically, hormone therapy is expected to control prostate cancer for at least 1-4 years and possibly for as long as 10 years or more. Eventually, the prostate cancer cells adapt to lack of hormones and begin to grow again.
What are the side effects of Hormone Therapy for Prostate Cancer?
Hormone therapy has been used widely to treat prostate cancer. It works by suppressing or depriving the production of the androgen hormones as high level of androgens increases the risk of acquiring prostate cancer.
However, male sex hormones are responsible for both sexual and physical health in males. They aid in muscle building, play a great role in your libido, and contribute to your vitality and overall wellness. Since the prostate gland is not the only organ requiring the androgens, deprivation of androgens has a wide range of side effects. Here are some of the side effects that are as a result of hormone therapy for prostate cancer:
- Loss of bone density
- Decreased interest in sex
- Hot flashes
- Insulin resistance
- Changes in blood lipid
- Growth of breast tissue
- Weight gain
- Bone fractures
- Erectile dysfunction
- Loss of muscle mass and physical strength
What can be done to reduce the side effects of Hormone Therapy?
Fortunately, the effect of hormone therapy for prostate cancer can be reduced in various ways. Loss of bone mass can be addressed by use of prescribed drugs such as alendronate that help to reverse this loss. Exercise may help to reduce some side effects such as weight gain, insulin resistance, fatigue, muscle loss, and bone loss. However, sexual side effects are difficult to deal with.
Hormone therapy has done wonders in most men with prostate cancer. In the case where it is impossible to kill or remove cancer, hormone therapy has been used to slow down its growth.
However, it is associated with some of the side effects of which some are reversible. If possible it is important to consider a therapy that has fewer side effects and more so one whose side effects are reversible. Combining some type of therapies is definitely bound to better results. The important thing is to understand how hormone therapy works and which method, drugs or combination of drugs works best. Although hormone therapy, isn’t a cure for prostate cancer, this kind of therapy can help men with prostate cancer feel better and add years to their lives.
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