Hormone therapy is often used in combination with radiotherapy and is used in the treatment of prostate cancer.
Key points
- Targeted treatment
- Often combined with other treatments
- Available in various forms
- High success rates
- Manageable side effects
Why choose Urocare?
At Urocare London, our commitment to excellence in urology is driven by the expertise and dedication of our leading specialist, Mr. Maneesh Ghei. Located at leading private hospitals in London, Urocare London offers the convenience and accessibility you need.
What is hormone therapy?
Hormone therapy, also known as androgen deprivation therapy (ADT), reduces or stops the production of androgens (male hormones) like testosterone, which prostate cancer cells rely on to grow. By lowering these hormone levels, the growth of cancer cells is slowed down, providing an effective means of managing prostate cancer at various stages.
Types of hormone therapy for prostate cancer
There are 3 types of hormone therapy:
- Anti-androgen: These are tablets to block the effects or reduce the production of testosterone
- LHRH agonists: These are injections to stop the production of testosterone, called luteinising hormone-releasing hormone (LHRH) agonists
- LHRH antagonists: These are injections to stop the production of testosterone.
Who is hormone therapy suitable for?
Hormone therapy is most suitable for:
- Patients undergoing concurrent radiotherapy: It enhances the effectiveness of radiotherapy in controlling localised or regionally advanced prostate cancer.
- Post-surgical patients: To minimise the risk of recurrence, hormone therapy may be advised after surgical interventions such as prostatectomy.
- Advanced cancer cases: For those with metastatic prostate cancer, hormone therapy is crucial in controlling the disease’s spread and managing symptoms.
How does hormone therapy work?
The process involves:
- Inhibiting Hormone Production: Using drugs like LHRH agonists and antagonists to reduce the body’s testosterone production.
- Blocking Hormonal Effects: Anti-androgens prevent testosterone from activating prostate cancer cells by blocking the receptors that cancer cells use to receive hormonal signals.
How is hormone therapy administered?
- Injections: This typically involves periodic injections (monthly or quarterly) of LHRH agonists or antagonists, which can be administered in a clinical setting.
- Tablets: Anti-androgens are available as oral tablets, providing a non-invasive treatment option that patients can conveniently take at home.
How successful is prostate cancer hormone therapy?
The effectiveness of hormone therapy is well-documented, with most patients showing a favourable response. The therapy is particularly effective in reducing PSA levels, delaying cancer progression, and extending survival rates, especially in advanced stages of prostate cancer.
What to expect after hormone therapy
Following hormone therapy, patients may experience a significant reduction in cancer-related symptoms. However, the impact on testosterone levels can lead to several temporary side effects. Regular follow-ups are necessary to monitor the patient’s response to the treatment and adjust the therapy as needed.
Side effects of hormone therapy
Common side effects include:
- Emotional and Physical Changes: Reduced testosterone levels can lead to mood swings, fatigue, and changes in body composition.
- Sexual Health Issues: Decreased libido and erectile dysfunction are notable side effects, impacting sexual health and quality of life.
- Bone Density and Muscle Mass: Prolonged therapy may affect bone density and muscle mass, necessitating monitoring and possible treatment.
Alternative treatments to hormone therapy
Alternatives may include:
- Surgical Options: Such as radical prostatectomy, which involves the removal of the prostate gland.
- Radiation Therapy: Either external beam radiation or brachytherapy to target cancer cells directly.
- Active Surveillance: Monitoring cancer closely without immediate treatment in cases of low-risk, slow-growing prostate cancer.
Frequently asked questions
How long is hormone therapy required?
The duration of hormone therapy varies depending on the cancer’s stage, overall health of the patient, and how well the cancer is responding to treatment. Some patients might need short-term therapy (a few months), while others might need long-term treatment for several years or indefinitely.
What are signs that hormone therapy is effective?
Signs of effective hormone therapy include a decrease in prostate-specific antigen (PSA) levels, reduction in cancer-related symptoms (e.g., less bone pain), slowed progression of the disease, and in some cases, shrinkage of the prostate and any metastases.
Can I stop hormone therapy if side effects are intolerable?
It is important to discuss any side effects with your doctor before stopping the therapy. In many cases, adjustments can be made either by changing the type of hormone therapy or by adding medications to manage side effects.
Are there any long-term effects of hormone therapy for prostate cancer?
Long-term effects can include bone thinning (osteoporosis), changes in body composition (like increased body fat and reduced muscle mass), and cardiovascular risks. Regular monitoring and preventive measures, such as bone-strengthening medications and cardiovascular health management, are important.
Is hormone therapy considered chemotherapy?
No, hormone therapy is not considered chemotherapy. While both treatments are systemic, targeting cancer cells throughout the body, chemotherapy uses cytotoxic drugs to kill cancer cells, whereas hormone therapy specifically aims to block hormones that fuel cancer growth.
Can lifestyle changes impact the effectiveness of hormone therapy?
Lifestyle factors, such as diet, exercise, and managing stress, can impact the overall health of cancer patients and may influence the effectiveness of treatments like hormone therapy. A balanced diet, regular physical activity, and stress management are recommended.
Can hormone therapy be used for all types of prostate cancer?
Hormone therapy is primarily used for prostate cancers that are sensitive to hormones, particularly those that have spread beyond the prostate or returned after initial treatment. It is not typically used for non-metastatic or very slow-growing, localised cancers.