Prostate cancer is the second leading cause of cancer deaths amongst American men. While most cases of prostate cancer are caught early and can be effectively treated with surgical and radiation therapies, some cases do become advanced and require different prostate cancer therapy options. Often the goal advanced prostate cancer therapy is not to cure the cancer, but instead aim to reduce the growth and spread of the cancer and lengthen the patient's survival.
One advanced prostate cancer therapy option is hormonal therapy. There are several different types of hormonal therapy, but all aim to inhibit the production or the action of androgen hormones, specifically testosterone. Androgens have been shown to cause prostate cancer cells to grow, so by inhibiting their production or their action, the growth of the tumor is often greatly slowed and sometimes even halted or reversed.
One such hormonal prostate cancer therapy is orchiectomy. Orchiectomy is the surgical removal of the testes, the organs that produce almost 95% of the body's androgens. An orchiectomy is often a simple outpatient procedure with few risks, other than those associated with all surgeries requiring anesthesia. Androgen levels in the body drop dramatically following an orchiectomy, and most patients have rapid relief from many symptoms. There are, however, disadvantages to this type of prostate cancer therapy. The main side effects of orchiectomy are decreased libido, impotence, hot flashes and osteoporosis. Furthermore, an orchiectomy is permanent and can not be reversed.
There are, however, reversible hormonal prostate cancer therapy options that have the same efficacy as orchiectomy. These hormonal prostate cancer therapy options involve the administration of certain hormone-blocking or inhibiting drugs. The most commonly used drug therapies is LHRH analogs. These drugs act like the body's own luteinzing hormone-releasing hormones, which regulate testosterone production. The addition of these LHRH analogs effectively suppresses testosterone production. The effects are not as immediate as orchiectomy, but over time the effects are similar. In the same vein, the side effects of LHRH analog drug therapy are similar to those of orchiectomy, including decreased libido, impotence, hot flashes and osteoporosis. Fortunately, if any of these side effects become too much, they are subside with discontinuation of drug therapy.
There are other types of hormonal drug therapy, including estrogen therapy and total androgen blockade, but these are usually used in conjunction with LHRH analog therapy to enhance its effects. Researchers are not in agreement as to whether these combined therapies are more or less effective that singular therapy. Furthermore, estrogen therapy carries significant risks including blood clots and strokes, so its use is on the decline.
Hormone therapies have a short-lived effect of one to two years. Some patients may not benefit as long, while others may see even longer benefits. Overall, hormone therapies are not curative, but do play a roll in maintaining quality of life and extending survival time in many patients.