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Hormone therapy for prostate cancer is also known as
androgen deprivation therapy (ADT).
Prostate cancer cannot grow or survive without
androgens, which include
testosterone and other male hormones. Hormone therapy
decreases the amount of androgens in a man's body. Reducing androgens can slow
the growth of the cancer and even shrink the tumor.
Hormone therapy may be used:
When hormone therapy slows the growth of prostate cancer, a man's prostate-specific antigen (PSA) levels will go down. PSA tests will show if the treatment is working.
Taking medicine, such as luteinizing hormone-releasing hormone (LHRH) medicine, is one way
to reduce androgens.
Other hormone therapies may include the use of
medicines such as aminoglutethimide
combined with hydrocortisone, corticosteroids (dexamethasone,
hydrocortisone, and prednisone), estrogen, and megestrol.
Another way, used much less often, is surgery to remove
the testicles, also known as an orchiectomy. This surgery is considered to be hormone
therapy. This is because removing the testicles, where more than 90% of the
body's androgens are made, decreases testosterone levels. Removing the
testicles may be the simplest way to reduce androgen levels, but it is permanent.
Research does not clearly show whether starting hormone therapy before symptoms appear allows men to live longer than if they waited until after symptoms appear to start taking medicine.footnote 1 Men who start hormone therapy almost always stay on it for the rest of their lives. So waiting until symptoms appear may allow men to delay the serious side effects of hormone therapy.
The side effects of hormone therapy increase with the length of time that a man uses this therapy. Some of the side effects from hormone therapy will go away when a man who
is taking medicine finishes his hormone therapy. For a man who has an
orchiectomy, the side effects of sterility and loss of sexual interest are
immediate and permanent.
Side effects of hormone therapy may
Other side effects may include hot flashes, erection problems and reduced sex drive, breast enlargement, and cognitive impairment. Some men may experience depression.
See Drug Reference for a full list of side effects. (Drug
Reference is not available in all systems).
long-term side effects of hormone therapy, even for men taking medicine, are
not known. But hormone therapy has been linked to a higher risk for diabetes, cardiovascular disease, and a shorter life span.footnote 1
One large study found that
hormone therapy appears to be linked to a higher risk of death from heart
problems in men who had surgery for localized prostate cancer.footnote 2
The side effects of hormone therapy for prostate
cancer often affect a man's quality of life. But there are treatments that can
help with some of the side effects listed above. For example, exercise can help
counteract the loss of muscle mass and will help with fatigue. There are
medicines that can help with hot flashes, nausea, diarrhea, and bone loss. Low-dose radiation or taking tamoxifen may help prevent or reduce breast enlargement. For men
with depression, counseling and medicine may help. For more information, see
the topic Depression.
Above all, talk with your doctor about any
of the symptoms you have while you are taking hormone therapy. Your doctor may
know about a local support group for men who have prostate cancer.
Nelson JB (2012). Hormone therapy for prostate cancer. In AJ Wein et al., eds., Campbell-Walsh Urology, 10th ed., vol. 3, pp. 2934–2953. Philadelphia: Saunders.
Tsai HK, et al. (2007). Androgen deprivation therapy for localized prostate cancer and the risk of cardiovascular mortality. Journal of the National Cancer Institute, 99(20): 1516–1524.
ByHealthwise StaffPrimary Medical ReviewerE. Gregory Thompson, MD - Internal MedicineSpecialist Medical ReviewerChristopher G. Wood, MD, FACS - Urology, Oncology
Current as ofNovember 20, 2015
Current as of:
November 20, 2015
E. Gregory Thompson, MD - Internal Medicine
& Christopher G. Wood, MD, FACS - Urology, Oncology
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