Hormonal Therapy With Radiotherapy
Hormonal therapy is often used to treat early and locally advanced prostate cancer. If you have low-risk early prostate cancer you do not usually need hormonal therapy.
Doctors often advise having hormonal therapy with radiotherapy , to make your treatment more effective. You may have hormonal therapy before, during and after radiotherapy. It can be given:
- a few months before radiotherapy, to shrink the cancer
- after radiotherapy, to reduce the chance of the cancer coming back .
Your doctor will talk to you about how long you take hormonal therapy for. They will also explain the possible side effects.
When Hormone Therapy Is Indicated
HT can be administered before, during or after a localized treatment, such as radical prostatectomy, radiation, high-intensity focused ultrasound or cryotherapy. When given before a localized treatment, it is called neoadjuvant therapy. When given after localized treatment without evidence of prostate cancer recurrence, it is called adjuvant therapy. When HT is prescribed after localized treatment for a prostate cancer recurrence, it is called salvage therapy. If a patient’s PSA starts rising after a radical prostatectomy, HT is typically given in combination with radiation therapy. Treatment recommendations are based on each patient’s specific circumstances.
Sometimes we give neoadjuvant HT while the patient is deciding on his primary treatment or to reduce the tumor’s size before starting primary treatment. Neoadjuvant HT will usually slow or stop cancer growth for a period of time.
Many radiation oncologists use HT along with radiation treatment in the belief that HT weakens cancer cells so that they’re more susceptible to destruction by the radiation. Clinical studies have suggested a synergy between radiation therapy and hormone therapy meaning they work better together. Clinical trials have shown improved outcomes for patients who receive combined therapy.
What Are Male Sex Hormones
Hormones are substances that are made by glands in the body. Hormones circulate in the bloodstream and control the actions of certain cells or organs.
Androgens are a class of hormones that control the development and maintenance of male characteristics. The most abundant androgens in men are testosterone and dihydrotestosterone .
Androgens are required for normal growth and function of the prostate, a gland in the male reproductive system that helps make . Androgens are also necessary for prostate cancers to grow. Androgens promote the growth of both normal and cancerous prostate cells by binding to and activating the androgen receptor, a protein that is expressed in prostate cells . Once activated, the androgen receptor stimulates the expression of specific genes that cause prostate cells to grow .
Almost all testosterone is produced in the testicles a small amount is produced by the adrenal glands. Although prostate cells do not normally make testosterone, some prostate cancer cells acquire the ability to do so .
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Risk Of Heart Problems
Hormone therapy for prostate cancer might increase the risk of heart problems if you have certain medical conditions.
This may be because some of the side effects of hormone therapy, such as weight gain, can make heart disease worse.
Gynecomastia in Patients with Prostate Cancer: A Systematic Review
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What Kinds Of Medical Information Should I Keep
It is important for you to keep a copy of your prostate cancer treatment records. You may not always see the same doctor for your follow-up care, so having this information to share with another doctor can be very helpful. The following is a list of medical information you may want to keep.
Remember, you have the right to copies of all your medical paperwork and the actual slides, x-rays and any other information about your health care and treatment. A good idea would be to create two copies of your medical information and keep them in folders. Keep one folder at home and take the other one with you to your doctors appointments. Whenever you see a new doctor, it is important for you to let them know about your prostate cancer and any treatment that you have had.
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How Often And For How Long Will I Need Hormone Therapy
How often you have hormone therapy will depend on the type of drug you are receiving and the type of cancer treated. Some medications need to be administered monthly, while others dont have to be administered quite as frequently.
In regards to how long hormone therapy will last, this will vary based upon the type of cancer you have and how well you are responding to treatment. For some people, it could continue for a few months. However, it is normal to need to continue with hormone therapy for several years. A common example is women undergoing hormone therapy for breast cancer it is normal to continue with treatment for five to seven years.
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Drugs That Lower Androgen Levels
The most common treatment is to take drugs that lower the amount of androgens made by the testicles. They are called luteinizing hormone-releasing hormone analogs and anti-androgens . These drugs lower androgen levels just as well as surgery does. This type of treatment is sometimes called chemical castration.
Men who receive androgen deprivation therapy should have follow-up exams with the doctor prescribing the drugs:
- Within 3 to 6 months after starting therapy
- At least once a year, to monitor blood pressure and perform blood sugar and cholesterol tests
- To get PSA blood tests to monitor how well the therapy is working
LH-RH analogs are given as a shot anywhere from once a month to every 6 months. These drugs include:
LH-RH antagonists are another class of treatments, including degarelix and relugolix . They reduce androgen levels more quickly and have fewer side effects. LH-RH antagonists are used in men with advanced cancer.
Some doctors recommend stopping and restarting treatment . This approach appears to help reduce hormone therapy side effects. However, it is not clear if intermittent therapy works as well as continuous therapy. Some studies indicate that continuous therapy is more effective or that intermittent therapy should only be used for select types of prostate cancer.
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Types Of Hormone Therapy For Prostate Cancer
There are many kinds of hormone therapy. Sometimes two or more types are used together. These are the most common ones:
Androgen deprivation therapy keeps your testicles from making androgens. Its often the first kind of hormone therapy you get for prostate cancer. Doctors can do it any of these ways:
- Orchiectomy is surgery to remove your testicles. Its also called surgical castration.
- LHRH agonists are drugs that stop your testicles from making androgens. You get them in shots or as implants put under your skin.
- LHRH antagonists are another group of drugs that keep your testicles from making androgens. They can be taken as pills or given as shots.
Using drugs to stop your testicles from making androgens is called medical castration. Both methods work equally well, but surgical castration is permanent.
Androgen receptor blockers, or anti-androgen drugs, keep androgens from working. They block the proteins on cells where these hormones attach. So even though there are androgens in your body, the cancer cells cant use them as fuel to grow. You take these drugs as pills. Theyre usually added to ADT if it stops working.
Androgen synthesis inhibitors are drugs that keep all parts of your body from making androgens. This includes your adrenal glands and even prostate cancer cells, both of which can make small amounts of androgens. You take these drugs as pills.
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Study Shows Group Exercise And Nutrition Program Prevents Fat Gain And Strength Loss
- Ohio State University
- Men on hormone therapy for prostate cancer may benefit significantly from hitting the gym with fellow patients and choosing more veggies and fewer cheeseburgers, a new study suggests.
Men on hormone therapy for prostate cancer may benefit significantly from hitting the gym with fellow patients and choosing more veggies and fewer cheeseburgers, a new study suggests.
Androgen deprivation therapy is a powerful tool against prostate cancer, and more and more men are opting for the treatment as a growing array of hormone-based therapies become available.
But it comes with a cost. Suppressing male hormones, including testosterone, that fuel cancer growth also means that patients lose strength and muscle mass and gain fat. And that puts the men at risk for other health problems, including heart disease and diabetes.
But diet and moderate exercise proved to be valuable tools in fending off those side effects in the new research from The Ohio State University. The study appears in the journal Annals of Behavioral Medicine.
“We found that a comprehensive exercise and diet program in a group setting can make a difference for prostate cancer patients, and the difference was greater than I expected in a short period of time,” said lead author Brian Focht, a professor of human sciences at Ohio State.
The National Cancer Institute supported the study.
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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.
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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New Study Compares Long
- By Charlie Schmidt, Editor, Harvard Medical School Annual Report on Prostate Diseases
Prostate cancer therapies are improving over time. But how do the long-term side effects from the various options available today compare? Results from a newly published study are providing some valuable insights.
Investigators at Vanderbilt University and the University of Texas MD Anderson Cancer Center spent five years tracking the sexual, bowel, urinary, and hormonal status of nearly 2,000 men after they had been treated for prostate cancer, or monitored with active surveillance . Cancers in all the men were still confined to the prostate when diagnosed.
Dr. Karen Hoffman, a radiation oncologist at MD Anderson and the studys first author, said the intent was to provide information that could help men choose from among the various therapeutic options. Surgical and radiation techniques have changed significantly in the last few decades, and at the same time, active surveillance has become an increasingly acceptable strategy, she said. We wanted to understand the adverse events associated with contemporary approaches from the patients perspective.
Roughly two-thirds of the men enrolled in the study had favorable risk cancer, which is nonaggressive and slow-growing. A quarter of these men chose active surveillance, and the rest were treated with one of three different methods:
Increase In Body Fat And Loss Of Muscle
Hormone therapy for prostate cancer can cause weight gain. You may notice that body fat starts to increase in certain areas, particularly around the breast. This may give your body a more feminine look that can be upsetting for some men. Discuss any changes in your body shape with your doctor or nursing team, particularly if they are worrying you.
Muscles can shrink with age and lack of use but loss of muscle mass may also be due to decreased testosterone levels. This may translate into an increased difficulty in carrying out usual physical tasks such as gardening, walking, or lifting and moving things.
Staying supple and performing the strengthening exercises outlined in the Feel+ programme may help you compensate for these effects and help you increase muscle mass and strength.
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What Types Of Hormone Therapy Are Used For Prostate Cancer
Hormone therapy for prostate cancer can block the production or use of androgens . Currently available treatments can do so in several ways:
- reducing androgen production by the testicles
- blocking the action of androgens throughout the body
- block androgen production throughout the body
Treatments that reduce androgen production by the testicles are the most commonly used hormone therapies for prostate cancer and the first type of hormone therapy that most men with prostate cancer receive. This form of hormone therapy includes:
Treatments that block the action of androgens in the body are typically used when ADT stops working. Such treatments include:
Treatments that block the production of androgens throughout the body include:
Hormone Therapy For Prostate Cancer
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Hormone therapy is also called androgen suppression therapy. The goal of this treatment is to reduce levels of male hormones, called androgens, in the body, or to stop them from fueling prostate cancer cell growth.
Androgens stimulate prostate cancer cells to grow. The main androgens in the body are testosterone and dihydrotestosterone . Most androgens are made by the testicles, but the adrenal glands as well as the prostate cancer cells themselves, can also make androgens.
Lowering androgen levels or stopping them from getting into prostate cancer cells often makes prostate cancers shrink or grow more slowly for a time. But hormone therapy alone does not cure prostate cancer.
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What Is Hormone Therapy
Hormones occur naturally in your body. They control the growth and activity of normal cells. Testosterone is a male hormone mainly made by the testicles.
Prostate cancer usually depends on testosterone to grow. Hormone therapy blocks or lowers the amount of testosterone in the body.
Hormone therapy on its own doesnt cure prostate cancer. But it can lower the risk of an early prostate cancer coming back when you have it with other treatments. Or it can shrink an advanced prostate cancer or slow its growth.
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Managing the sideeffects of hormone therapy 14 Loss of sex drive and erectile dysfunction 15 Hot flushes 20 Bone thinning 24 Breast swelling and tenderness 26 For men with prostatecancer, hormone therapy can be used to control the balance of the male hormone testosterone. Mar 15, 2021 · The standard treatmentfor prostate cancer that has come back after prostatectomy is radiation therapy, either alone or with the addition of hormonetherapy. Because hormonetherapy can cause distressing sideeffectsincluding hot flashes, loss of energy, and loss of sexual desirethe treatment is typically reserved for patients with . Hormonetherapyfor prostatecancer can cause weight gain. You may notice that body fat starts to increase in certain areas, particularly around the breast. This may give your body a more feminine look that can be upsetting for some men. Discuss any changes in your body shape with your doctor or nursing team, particularly if they are worrying .
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Side Effects Of Hormone Therapy In Men
Many men find that the side effects are often worse at the start of treatment. They usually settle down after a few weeks or months.
The side effects you might have depend on the type of hormone therapy that you are having.
Some side effects are common to all hormone therapies. Some vary from drug to drug. You might not have all of these side effects.
When Is Hormone Therapy Used
Hormone therapy may be used:
- If the cancer has spread too far to be cured by surgery or radiation, or if you cant have these treatments for some other reason
- If the cancer remains or comes back after treatment with surgery or radiation therapy
- Along with radiation therapy as the initial treatment, if you are at higher risk of the cancer coming back after treatment
- Before radiation to try to shrink the cancer to make treatment more effective
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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.
What Are The Advantages Of Orchiectomy
First, it is a single, simple, surgical procedure with a very low risk of problems and 100 percent efficacy.
Second, it can be carried out in ways which are not physically evident. In other words, it is possible to carry out what is known as a subcapsular orchiectomy, in which the cores of the two testes are removed while the capsules remain in the scrotum. This means that the man still appears to be an intact male.
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