How Hormone Therapy Works
Hormone therapy can be obtained via surgery, injections, or pills. The surgery takes out the hormone-producing organs, predominantly the testes in men and ovaries in women.
Male hormones act like a source of fuel for cancer. Without an adequate hormone supply, the tumor wont thrive. Hormone treatment is meant to slowly yet surely starve the tumor from its much-needed hormone supply. It basically provides an androgen blockage.
Androgen deprivation puts a lid on testosterone release, thus preventing testosterone from acting on the prostate cancer cells. Androgen deprivation can be used in advanced prostate cancer to reduce the tumor.
When used in locally advanced prostate cancer, the therapy can make external beam radiation therapy more effective in curbing the risk of prostate cancer recurrence.
In certain individuals, the cancer cells respond well to the drop in testosterone level. But, for others, the block of testosterone is not enough. These cancer cells can thrive independently of testosterone. Therefore, the therapy wont affect them.
What Is Hormone Herapy
To help you understand what hormone therapy is and how it may affect your prostate cancer, it is good for you to understand what hormones are and how they work in your body. Hormones control or manage your bodys activities. Hormones are made by glands in your body and are carried by your blood to all areas in your body. Glands are groups of cells in your body that make and release materials needed by your body.
Testosterone is the main male hormone in your body. It makes you grow hair on your face and body and have a mans body shape and controls your desire for sex. Testosterone also controls your prostate gland. Your testicles make most of the testosterone in your body. A small amount of testosterone is also made by your adrenal glands. Your adrenal glands are located on top of each kidney. Your adrenal glands also make other hormones.
Prostate cancer is hormone sensitive or hormone dependent. This means that the testosterone in your body helps your prostate cancer to grow. The goal of hormone therapy is to lower the amount of testosterone in your body to stop or slow the growth of your prostate cancer. You can lower the amount of testosterone in your body by taking medicines or having surgery.
How You Can Manage Or Minimize The Side Effects
Talk to your doctor. The sexual adverse effects are some of the most difficult problems to deal with. To manage ED, people often take ED drugs like . For those who experience bone loss, your doctor might prescribe drugs that slow or reverse this side effect.
Regular physical activity can curb some of these reactions of localized prostate cancer. If you are taking pharmacologic androgen or need to block the testosterone, see how your body is reacting to it. If you notice any changes, consult with a specialist.
Usually, the side effects go away once the patient stops taking the therapy. At other times, men like to use herbal medicine or supplements.
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Problems Getting An Erection
Hormone therapy lowers the amount of testosterone in the body and this affects your ability to have and maintain an erection. This may get better within 3 to 12 months after the treatment ends.
For some men, erection problems are permanent. It depends on the drug you are having and how long you have been taking it.
Your doctor or clinical nurse specialist will be able to offer you advice.
Hormone Therapy For Prostate Cancer
Roughly 1 in 8 men will be diagnosed with prostate cancer. Around 6 in 10 cases are recorded in patients older than 65. But, rarely in anyone under 40. Based on 2021 reports, there are about 248,530 new prostate cancer cases.
For some prostate cancer patients, hormone therapy is a practical choice for tackling the ailment. According to one report, the survival rate at 10 years in 56 patients with well-differentiated prostate cancer mitigated with primary hormone therapy was 100%.
In 85% 90% of advanced prostate cancer cases, hormonal therapy can diminish the size of the tumor. Good candidates for androgen deprivation therapy are men who already had their prostate cancer removed.
Hormone therapy medicines can be a viable choice for patients looking to boost the effectiveness of surgery as well as for those who already had primary treatment and had their prostate cancer return.
The therapy is here to mitigate advanced prostate cancer and interfere with tumor growth. It might relieve the signs of the affected prostate cancer cells. But, just like any therapy for cancer out there, androgen deprivation can cause adverse reactions.
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Pain From Tumour Flare
Pain caused by a secondary prostate cancer can temporarily worsen when you start hormone treatment. This is called tumour flare.
Your doctor should always prescribe another hormone therapy when you start leuprorelin or goserelin injections. This other hormone therapy helps to prevent tumour flare from causing bone pain. If the pain carries on, your doctor can prescribe drugs called bisphosphonates to treat it.
What To Expect During Hormone Therapy
As you go through hormone deprivation therapy, youâll have follow-up visits with your cancer doctor. Theyâll ask about side effects and check your PSA levels.
Doctors donât know how long hormone therapy works to keep prostate cancer in check. So, while you take it, your doctor will regularly draw blood to check your PSA levels. Undetectable or low PSA levels usually mean that the treatment is working. If your PSA levels go up, itâs a sign that the cancer has started growing again. If this happens, your cancer is considered castrate-resistant, and hormone deprivation therapy is no longer an effective treatment.
Youâll also get other blood tests to see if the cancer is affecting other parts of your body like your liver, kidneys, or bones. Scans will show how well your cancer is responding to hormone therapy.
To lessen the side effects of hormone therapy drugs, researchers suggest that you take them for just a set amount of time or until your PSA drops to a low level. If the cancer comes back or gets worse, you may need to start treatment again.
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How Will I Know That My Hormone Therapy Is Working
Doctors cannot predict how long hormone therapy will be effective in suppressing the growth of any individual mans prostate cancer. Therefore, men who take hormone therapy for more than a few months are regularly tested to determine the level of PSA in their blood. An increase in PSA level may indicate that a mans cancer has started growing again. A PSA level that continues to increase while hormone therapy is successfully keeping androgen levels extremely low is an indicator that a mans prostate cancer has become resistant to the hormone therapy that is currently being used.
Cancers Treated With Hormone Therapy
Hormone therapy is used to treat prostate and breast cancers that use hormones to grow. Hormone therapy is most often used along with other cancer treatments. The types of treatment that you need depend on the type of cancer, if it has spread and how far, if it uses hormones to grow, and if you have other health problems.
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Finding Hormone Balance And Improved Health
When given in appropriate doses bioidentical hormones are safe. If you are taking pellet therapy and not feeling better be sure to get a clear idea of what your levels are through out the treatment not just when the hormones are at the end of their cycle. If you have not tried hormone replacement therapy and are considering your options, you may want to try another form prior to having hormone pellet therapy. To get a personalized hormone replacement plan click on the link below.
Reference list Handelsman DJ, Mackey MA, Howe C, Turner L, Conway AJ. An analysis of testosterone implants for androgen replacement therapy. Clin Endocrinol 1997 47:3116. doi: 10.1046/j.1365-2265.1997.2521050.x.
Kelleher S, Conway AJ, Handelsman DJ. A randomised controlled clinical trial of antibiotic impregnation of testosterone pellet implants to reduce extrusion rate. Eur J Endocrinol. 2002 146:5138. doi: 10.1530/eje.0.1460513.
11. Kelleher S, Conway AJ, Handelsman DJ. Influence of implantation site and track geometry on the extrusion rate and pharmacology of testosterone implants. Clin Endocrinol 2001 55:5316. doi: 10.1046/j.1365-2265.2001.01357.x
How Does Hormone Therapy Work Against Prostate Cancer
Early in their development, prostate cancers need androgens to grow. Hormone therapies, which are treatments that decrease androgen levels or block androgen action, can inhibit the growth of such prostate cancers, which are therefore called castration sensitive, androgen dependent, or androgen sensitive.
Most prostate cancers eventually stop responding to hormone therapy and become castration resistant. That is, they continue to grow even when androgen levels in the body are extremely low or undetectable. In the past, these tumors were also called hormone resistant, androgen independent, or hormone refractory however, these terms are rarely used now because the tumors are not truly independent of androgens for their growth. In fact, some newer hormone therapies have become available that can be used to treat tumors that have become castration resistant.
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Managing The Side Effects Of Hormone Therapy
Before hormone therapy begins, talk with your doctor about what side effects could happen and how they can be managed. Ask questions about anything that is unclear to you. This will help you feel more prepared if you start experiencing those side effects. Let your health care team know about any new or worsening medical problems you have as soon as possible. This is important to do even if you do not think your symptoms are serious or related to your hormone therapy. Tracking your side effects can make getting the relief you need easier. One way to track side effects is using the free Cancer.Net Mobile app. You can securely record when side effects occur and their severity, and you can easily share these details with your health care team to describe your experience.
Some people may need to take hormone therapy for a long time. Working with your health care team to manage side effects can help maintain quality of life while on this kind of extended cancer treatment.
For Use In Certain Men
Some men with unnaturally low levels of testosterone can benefit from hormone therapy. For example, the condition hypogonadism can cause unnaturally low levels of testosterone. Its a dysfunction of the testicles that prevents the body from producing the right amount of testosterone.
Whats less certain is whether testosterone therapy can benefit healthy men whose testosterone decline is simply caused by aging. This has been a difficult question for researchers to answer. Not many studies have observed the effects of testosterone therapy in men with healthy levels of the hormone. The studies that have were smaller and had unclear results.
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What To Know About Transgender Hormone Therapy Side Effects
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For many transgender men and women, hormone replacement therapy is an important component of their transitioning process, allowing them to develop physical traits aligned with their gender identity. Taking this step to feel more comfortable in your body is a big decision, and there are many factors to consider as you determine if gender-affirming hormone replacement therapy is right for you.
Below is an overview of hormone replacement therapy medications and side effects to help you learn more about the process.
Side Effects Of Hormonal Therapy
Side effects can happen with any type of treatment for cancer, but everyones experience is different. Some people have many side effects. Other people have few or none at all.
If you develop side effects, they can happen any time during, immediately after or a few days or weeks after hormonal therapy. Sometimes late side effects develop months or years after hormonal therapy. Most side effects go away on their own or can be treated, but some side effects may last a long time or become permanent.
Side effects of hormonal therapy will depend mainly on the type of hormonal therapy, the dose of a drug or combination of drugs and your overall health.
It is important to report side effects and your concerns about side effects to the healthcare team. Doctors may measure how severe certain side effects are. Sometimes hormonal drug therapy may need to be adjusted if side effects are severe.
The following are the most common side effects that people tend to experience with hormonal therapy.
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When Hormone Therapy Is Recommended
Hormone therapy is typically given to patients with intermediate- or high-risk prostate cancer. It may be used in the following ways:
- In combination with radiation, mostly for patients with high Gleason scores or other high-risk factors.
- After radiation or surgery when PSA rises, indicating a recurrence.
- As therapy for patients unsuitable for radiation or surgery.
- As therapy for metastatic prostate cancer . It may be given instead of or in combination with chemotherapy.
HT is usually not prescribed for:
- Patients choosing a localized treatment for low-risk prostate cancer
- Low-risk patients preferring to monitor their cancer on an active surveillance program
HT may be an option for patients who are not candidates for surgery, radiation or other localized treatment because of age, pre-existing health conditions or concerns about potential side effects of localized treatments.
Can Hormone Therapy Cure My Prostate Cancer
No, hormone therapy cannot cure your prostate cancer. The goal of hormone therapy is to stop or slow the growth of the prostate cancer cells in your body. Hormone therapy can shrink prostate cancer tumors and may stop or limit the spread of your prostate cancer. Hormone therapy is used to control your prostate cancer.
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Hormone Therapy Side Effects And How To Manage Them
Many men find the side effects to be worse at the start of hormone therapy for prostate cancer.
But, these adverse effects usually simmer down in a couple of weeks or months.
Their severity and impact vary based on the treatment you receive. Some are a regular occurrence and develop in all cancer patients. Others not so much. They depend on the drug you are taking.
Here, we will take a closer look at the side effects of hormone therapy for prostate cancer. Including the reactions that can happen with the treatment of any other cancer besides that of the prostate.
Why Should Men Use Bioidentical Hormone Therapy
There are plenty of reasons men should consider choosing bioidentical hormone replacement therapy to restore hormonal balance.
For example, men who restore testosterone to natural levels using testosterone replacement therapy have been shown to reduce their risk of heart attack and stroke1. Adequate levels of testosterone have also been linked to higher energy levels and healthy weight control. One study2 found that men treated with testosterone therapy experienced a reduction in fat mass and increases in muscle mass and strength. Other benefits of hormone therapy for men include enhanced sexual desire and performance, better bone density with aging and improved spatial performance in patients with Alzheimers disease3.
Men who have been treated with bioidentical hormone therapy report benefits such as:
- Boosted sexual performance
- Maintenance of lean body mass
Hormone replacement therapy using bioidentical hormones is an effective and natural option for restoring and balancing hormone levels in men. Conventional methods used to restore male hormone levels, such as synthetic hormones produced by pharmaceutical companies do not provide the tailored treatment necessary for achieving and maintaining optimal health.
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Take A Cautious Approach
A large, definitive trial for hormone treatment of men is still to come. Until then, here is how to take a cautious approach to testosterone therapy.
Take stock of your health first
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Have you considered other reasons why you may be experiencing fatigue, low sex drive, and other symptoms attributable to low testosterone? For example, do you eat a balanced, nutritious diet? Do you exercise regularly? Do you sleep well? Address these factors before turning to hormone replacement therapy for men.
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If your sex life is not what it used to be, have you ruled out relationship or psychological issues that could be contributing?
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If erectile dysfunction has caused you to suspect “low T” as the culprit, consider that cardiovascular disease can also cause erectile dysfunction.
Get an accurate assessment
Be mindful of unknown risks of testosterone replacement therapy
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Approach testosterone therapy with caution if you are at high risk for prostate cancer have severe urinary symptoms from prostate enlargement or have diagnosed heart disease, a previous heart attack, or multiple risk factors for heart problems.
- Ask your doctor to explain the various side effects for the different formulations of testosterone. The different treatments include testosterone injections, gels and patches. Know what to look for if something goes wrong.
Diabetes And Heart Disease
Hormonal therapy may increase your risk for diabetes and heart disease. Maintain a healthy lifestyle to help reduce this risk.
- Dont smoke or use tobacco products. If you currently smoke, the Tobacco Treatment Program can help you quit. Your healthcare team will refer you to this program for support, or you can call for more information.
- Maintain or achieve a healthy body weight. If youd like to meet with a clinical dietitian nutritionist, call .
- Follow a healthy diet. Your diet should be high in fiber, low in fat, and low in concentrated sweets. For more information, read Nutrition and Prostate Cancer: Making Healthy Diet Decisions.
- Exercise regularly. Examples include brisk walking, jogging, biking, aerobics, and yard work. We recommend you exercise 30 minutes every day in addition to your daily routine. Even if you cant exercise every day, whatever you can do will be helpful.
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