March 16, 2009 -- Question: What is hormone therapy, when is it used to treat prostate cancer, and what are the risks/side effects? (Please discuss how it's administered.)
Answer: Hormone therapy is the cornerstone of treatment for metastatic prostate cancer and has become a routine part of the treatment for many men with earlier staged disease.
Hormone therapy doesn't involve administration of hormones, but in fact strategies to dramatically lower the male hormone testosterone. Accordingly it's also termed androgen deprivation therapy. This can be accomplished in one of two ways, by either surgical removal of the testicles in a reversible form of hormone therapy or treatment with gonadotropin-releasing hormone agonists or GNRH agonists, medications that, like surgical removal of the testicles, dramatically lowers testosterone levels.
This a very effective form of treatment, results in disease responses or regression in nearly all men with prostate cancer and has dramatically altered the way we manage this disease. Because of dramatic changes in patterns of care, this treatment is often administered to men with earlier staged disease who have no symptoms from their cancer. And with that, there's become increasing concerns about the potential short and long term side effects of treatment. Those side effects include loss of sexual interest, loss of energy or fatigue, weight gain, increase in fat mass, loss of muscle mass. Some of these changes are important and have corresponding metabolic alterations that appear to increase the risk for both diabetes and cardiovascular disease.