Prostate Hormone Therapy   

The fact that the cells of prostate are hormone-dependent, hormone therapy is often considered in the treatment of prostate cancer. Indeed, prostate cancer is largely dependent on testosterone, the principal male sex hormone secreted by the testes and in small quantities (10 %) by the adrenal glands. Although can be useful, hormone therapy is not a curative treatment. Its main purpose is to oppose the androgenic stimulating action of the prostate cancer cells, slow the progression of cancer cells, and increase survival of patients while improving their quality of life.   

Typically, hormone therapy is used to treat patients with cancer that has spread beyond the boundaries of the prostate gland or has recurred following initial treatment. However, the therapy can also be used to treat cancer confined to the prostate in order to reduce the volume of prostate gland to make possible the surgery or allow better results from radiotherapy. In the case of very elderly patients, hormone therapy is used as a palliative treatment to relieve physical pain and other symptoms related to prostate cancer.  

Anti-androgens (hormone therapy drugs) work by lowering levels of testosterone produced by the testes which stimulates the proliferation of prostate cancer cells. The decrease in testosterone caused by the treatment led to a blockage of the division of cancer cells, thus reduces the volume of the prostate. These drugs are taken by mouth in the form of tablets. Anti -androgens are often used in combination with analogs of luteinizing-hormone-releasing hormone ( LHRH) because they block the small amount of testosterone secreted by the adrenal glands. Anti-androgens can also be recommended along with surgical removal of both testicles ( castration).  

However, some prostate cancers, initially or secondarily, do not respond to hormonal treatment; they are called hormone- resistant prostate cancer or hormone-refractory prostate cancer . The hormone resistance usually occurs a few years after the beginning of the hormone therapy. Even for cancers that respond well to the therapy, hormone therapy has a transient effect; it does not lead to cure. 

Hormone Therapy Effects  

Some of the hormone therapy drugs used to treat prostate cancer include leuprolide (Lupron, Eligard,), goserelin (Zoladex), triptorelin (Trelstar), bicalutamide (Casodex), flutamide, nilutamide (Nilandron) and degarelix (Firmagon). Although widely prescribed, the benefits of these drugs can be poor, and can cause complications or side effects. Side effects are frequent and sometimes serious; most common include:  

• diabetes
• heart attack
• weight gain
• fatigue
• erectile dysfunction
• warm, red condition of the skin (flushing)
• development of abnormally large breasts (gynecomastia)
• Bone disease that leads to an increased risk of fracture (osteoporosis).