Hormone therapy is another option for treating prostate cancer. It is most commonly used in the treatment of malignancies that have spread beyond the prostate.
The body produces hormones to control the growth and activity of healthy cells, but some of these hormones may stimulate the growth of the prostate cancer. The male hormone testosterone, which is produced by the testicles, appears to have a direct effect on the growth of prostate cancer.
Hormone therapy aims to limit the cancers access to testosterone, thereby ‘starving’ the cancer, thus reducing the growth of, or actually shrinking, and the tumour. This means that patients receiving hormone therapy may experience a reduction in their symptoms and possibly a reduction of their tumour that may last for a number of years. Reducing the size of the tumour is also useful when planning radiation therapy of the surgical removal of the prostate.
Testosterone is produced mainly in the testicles and the rate of production is controlled by the pituitary gland in the brain. There are two main methods of reducing the production of these hormones, the surgery method or through medication.
Surgical Hormone Therapy
Because testosterone is produced by the testicles, the quickest method of reducing its production is by removing part of the testicles; this procedure is known as an ‘Orchiectomy’. A/Prof Patel will make a small incision in the groin or scrotum while the patient is under general anaesthetic.
While this is a simple procedure that only requires one night in hospital, the recovery period may be painful and there are a number of possible side effects. Most of these symptoms can be treated with medication but there are also the psychological aspects related to the non-reversibility of the procedure to consider.
Medical Hormone Therapy
Hormone treatment using medication aims to produce the same result as the surgical method, which is to reduce the amount of testosterone available to the cancer. Although this process may take longer than the surgical method, results have shown that the efficacy of this treatment process is the same as the surgical method.
The medications work by suppressing the hormones produced by the pituitary gland in the brain, which stimulate the testes to create testosterone. The hormone drugs can be administered either as tablets or injections that can be administered at home or in hospital either monthly, quarterly or every 6 months.
What are the Side Effects of Hormone Therapy?
Both the surgical and medication procedures share common side effects, while there may also be additional side effects related to the medications that you are taking.
Common side effects include hot flushes, tiredness, decreased libido, erectile dysfunction (impotence), weight gain and gynaecomastia (the development of swollen breast tissue).
Most of these side effects can be treated or will pass with time.
It is important to realise that hormone therapy is not a cure and that some cancers can become hormone resistant. It is not known how this happens, but has been noted with both the medical and surgical methods.
A/Prof Patel will discuss treatment alternatives and possible side effects with you, so that you can make an informed decision about which treatment options are best for you.