HORMONE TREATMENT FOR PROSTATE CANCER
When prostate cancer has spread to other parts of the body such as the lymph nodes, bone, lung, or liver, hormone treatment is used. Once it has spread the disease cannot be cured by surgical means, or radiation. The cancer cells cannot be removed in one go as the cancer has spread. Hormone therapy treats the entire body, treating cancer cells too small to be detected. It is also used when the patient is judged not to be physically fit to withstand surgery.
Hormone treatment interferes with the production of male hormones or blocks the action of male hormones that promote prostate tumor growth. It is effective in shrinking the size of the cancer in most patients who are treated and these patients can expect to keep the cancer under control for many years.
Hormonal therapy is not a cure for prostate cancer; its aim is to slow down the growth of hormone dependant prostate cancer cells.
There are three main types of hormonal treatment.
* Surgical removal of the testicles, which produce the testosterone
* Antiandrogen therapy to block the effects of androgens such as testosterone
* Luteinizing Hormone-Releasing Hormone (LH-RH) Agonists
1. Orchiectomy
Orchiectomy used to known as Orchidectomy, and it is the surgical removal of the testicles, or medical castration. A side effect of this rather drastic cure is hot flushes, impotence and a loss of sexual desire. Before this operation is carried out your urologist may require more tests to verify the diagnosis.
A transillumination is the shining of a very bright light through the testicle, which will rule out the possibility of a benign cyst. An ultrasound will also be carried out, whereby; high-frequency sound waves are bounced off tissues inside the body. This is then converted into pictures; the majority of testicular will appear to be solid masses, as opposed to a cyst, which appears as fluid. Whilst ultrasound has a near perfect hundred percent record in detecting tumours, it cannot tell whether they are benign or not. Ninety five percent of tumours in testicles are malignant, and the only way to tell whether or not the cancer is malignant is to look at it under the microscope. However if it is cancer and it is disturbed it can progress through your body.
2. Antiandrogen therapy
Anti- androgens block the production testosterone, so the growth of the cancer is inhibited.
Anti - androgen therapy does not eliminate testosterone and therefore may have fewer or less severe side effects than those associated with surgical and medical castration. Often this treatment is prescribed intermittently with breaks in between.
Bizarrely the body demonstrates an "anti - androgen withdrawal effect." In simple English this means the patient benefits from withdrawing the treatment.
The three most common anti androgen drugs, used for prostate cancer hormone therapy are
* Flutamide,
* Bicalutamide,
* Nilutamide.
They are all oral tablets and it is recommended that they are taken at the same time each day to combat nausea. If there are more serious side effects discuss the matter with your doctor, who may change the medication, or encourage you to continue.
Side effects are usually found not to be too serious, though this can differ depending on whom is receiving the treatment.
Diarrhea is the chief consequence of having this treatment, although queasiness, liver problems, and fatigue can occur in a few patients. The major difference from taking LHRH agonists is anti-androgens have fewer sexual side effects which can only be a good thing for those men who still have an active sex life. When these drugs are used alone libido and potency are normally unaffected.
3. Luteinizing Hormone-Releasing Hormone (LH-RH) Agonists
These drugs are especially formulated to ease the symptoms of advanced prostate cancer. They are not a cure for the prostate cancer but in certain cases they can be as effective in diminishing the level of testosterone produced by the testicles as efficiently as an Orchiectomy. (Surgical removal of the testicles).
One of the reasons that the doctor does not use it as often as surgery is the expense of the drugs and the fact that the treatment needs more supervision from a medical point of view.
Lupron Depot (leuprolide acetate for depot suspension) is an LH-RH agonist used to care for symptoms connected to advanced cases of prostate cancer. Lupron Depot stops the tumor from feeding on the testosterone this slowing down the advance of the cancer.
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