| ||||||||||||||||||||||
|
Primary Hormone Therapy
By blocking androgens, hormone therapy causes prostate cancer to shrink, or to grow more slowly. It does not ‘cure’ the cancer, but can keep it at bay, or ‘in remission’ for several years. Hormone therapy blocks androgens from feeding the growth of prostate cancer by blocking either the production of testosterone or the cancer cell’s ability to use it.
How Hormone Therapy WorksLuteinizing hormone-releasing hormone (LH-RH) agonists stop the pituitary from instructing the testes to produce testosterone. LH-RH drugs make the pituitary release all of its Luteinizing Hormone (LH), which causes a ‘flare” of increased testosterone. This causes the pituitary to stop producing LH, which then stops the testes from producing testosterone. LH-RH agonist drugs are administered by injection every three or four months. Anti-androgens block the body’s ability to use all androgens, including those made by the adrenal glands, and can be used with LH-RH agonists to set up a total androgen blockade. They usually come in tablet form.
Side EffectsAbout 90 percent of men undergoing hormone therapy suffer from impotence and loss of sexual appetite. Other side effects are similar to those in women undergoing menopause, and may include hot flashes, growth of breast tissue, weight gain and reduction in muscle and bone mass. Most prostate cancers treated with hormone therapy eventually become androgen-independent (AIPC), or hormone-refractory (HRPC). They learn to live without androgens, and begin to grow again after a median of 16-24 months, though some take longer, some a shorter amount of time. These cancers need to be treated by other methods, some of which are available through participation in clinical research. Intermittent hormone therapy, or stopping hormone therapy whenever PSA levels return to stable low levels, is sometimes used in an attempt to prevent cells from developing resistance to treatment. Other drugs, such as estrogen or ketoconazole, can be used and may be effective after other drugs have stopped working. Sometimes hormone therapy is combined with surgery or radiation, either to shrink tumors in advance of treatment or to inhibit the growth of cancer cells in men with high risk of recurrence. As most testosterone is produced in the testicles, surgical removal of the testes, or orchiectomy, is also an effective way to block hormone production. Most men prefer to use hormone blockade drugs, even though they can be more expensive, as they work just as well as surgery and the effects are reversible.
Hormone Therapy Research NewsThe following information was compiled from previously published study results and news stories. This page was last updated on 07.15.2008
Hormone Therapy Missing the Mark for Early Prostate CancerHormone therapy fails to improve survival in older men with early prostate cancer that hasn't spread, according to a recent Medicare patient study conducted by the researchers at the Cancer Institute of New Jersey and the Robert Wood Johnson Medical School. The findings suggest the popular treatment may not be as beneficial as expected. The study showed that these drugs did not improve the chances for survival in older men whose disease had not spread. In fact, men given the drugs alone were slightly more likely to die of prostate cancer during the next six years than men who underwent medical monitoring, another common treatment approach for that age group. Hormone therapy is the second most-used treatment after surgery for early prostate cancer that hasn't spread, although the drugs aren't approved for that particular use. These medicines can produce side effects such as hot flashes and impotence and have been associated with osteoporosis and diabetes. "What we are saying is doing something may not always be the best choice, because given the overall picture, this doesn't really give you any proven benefit," said lead author Dr. Grace Lu-Yao. The researchers hope this study would prompt doctors to think twice before offering hormone-blocking drugs alone in older men whose disease hasn't spread.
Hormone Therapy Fails to Help Early Prostate Cancer
Vaccine More Effective When Combined with Hormone TherapyDespite recent reports questioning the benefits of hormone therapy, other research supports hormone therapy as a viable treatment option for many patients. Among patients with castration-resistant prostate cancer, adding hormone therapy after vaccine treatment improved overall survival when compared with treatment alone. "By using hormone therapy in prostate cancer you can help enhance your T-cell response to where the cancer is in the prostate gland, and you are also more likely to achieve a better immune response," said Philip M. Arlen, M.D., director of the Clinical Research Group for the Laboratory of Tumor Immunology and Biology, Center for Cancer Research, at the National Cancer Institute.
Prostate Cancer Vaccines More Effective With Hormone Therapy
Hormone Therapy for Advanced Prostate Cancer Not for EveryoneFor men with advanced prostate cancer, starting hormone therapy quickly comes with benefits and risks that may -- in some cases -- cancel each other out, according to new guidelines issued by the American Society of Clinical Oncology. While the guidelines still recommend the use of hormone blocking drugs in some cases, they warn that while hormone therapy could reduce the risk of dying from prostate cancer by 17 percent, it may also increase the risk of dying from something else by 15 percent. |  | ||||||||||||||||||||
| ||||||||||||||||||||||
