Hormonal Deprivation Therapy
Testosterone, the major male hormone in the body, stimulates prostate cancer growth. Hormonal deprivation therapy involves medication or orchiectomy (surgical removal of the testicles) to stop the production of testosterone or the effects of testosterone in the body. While not curative, hormonal deprivation can significantly slow the growth of prostate cancer, often delaying its progression for many years. Over time, hormone-resistant cancer cells eventually develop leading to cancer that is no longer responsive to hormonal treatments. Primary hormonal deprivation therapy is typically used for patients with metastatic (or widespread) prostate cancer that is beyond a curative stage.
Hormonal deprivation may also be used in conjunction with another therapy to optimize the ability to control the cancer. This is typically recommended for men with more aggressive prostate cancers who choose radiation therapy. In addition, hormonal therapy may be used after surgery if cancer is found in the lymph nodes or if cancer recurs during surveillance post-surgery. Finally, hormonal therapy may be combined with chemotherapy in select patients with newly diagnosed advanced metastatic prostate cancer.
The major side effects of hormone deprivation depend on the type of hormone therapy used. However, in general, the side effects may include decreased sexual desire or libido, hot flashes, fatigue, decreased bone density and mood alteration. Due to the risk of decreased bone density, physicians may recommend monitoring bone health as well as calcium and vitamin D supplementation and other preventive measures to avoid bone loss. Other longer term side effects may include increased risk of cardiovascular disease, hypertension, diabetes, high cholesterol and/or weight gain.
Advantages: Avoids invasiveness, inconveniences and potentially permanent side effects of surgery or radiation treatment. Treatment targets cancer cells throughout the body.
Disadvantages: Is not curative and does have the significant side effects as listed above.