What Hormone Therapy Does
Hormone therapy can control or shrink the cancer and reduce symptoms. It can help you feel better and improve your quality of life for a time but it cant cure the cancer.
Most men with advanced prostate cancer have hormone therapy. If your cancer has spread when it is diagnosed, you might start hormone therapy straight away.
If you dont have symptoms, your doctor might suggest monitoring your symptoms and then starting treatment when needed. They call this watchful waiting.
Your doctor might offer you a choice of treatment. And you might have more than one type of hormone therapy at the same time.
Taxotere Added To Hormone Therapy Improves Overall Survival By 13 Months In Metastatic Prostate Cancer Patients
In a study conducted by researchers at the Dana-Farber Cancer Institute, Taxotere® administered with androgen-deprivation therapy to metastatic prostate cancer patients was found to extend overall survival by more than 13 months. The results were reported at the 2014 American Society of Clinical Oncology meeting held in Chicago.
Prostate cancer occurs when the cells in the prostate gland grow out of control. They initially spread within the prostate and then grow through the capsule that covers the prostate into neighboring organs, or break away and spread through the bloodstream and lymphatic system to other parts of the body.
Cells in the prostate have testosterone receptors. When exposed to testosterone, prostate cells are stimulated to grow. The basis of hormone therapycalled androgen-deprivation therapy is to block or prevent the cancer cells from being exposed to testosterone.
The study included 790 men with hormone-sensitive metastatic prostate cancer. Patients were randomized to standard ADT or to ADT plus Taxotere, a chemotherapy drug. The primary endpoint of the study was overall survival. Due to a statistically significant survival difference observed between the two cohorts at an interim analysis, the trial was ended prematurely.
After 29 months, 136 patients in the control arm had died, while 101 patients in the ADT plus Taxotere group had died.
Other key results included:
How Often You Have Hormone Therapy
You usually have hormone therapy that you take all the time . Or you may have a few months of treatment and then a break . It’s thought that having intermittent therapy might reduce the side effects you get, but more research needs to be done to look into this.
You might have:
- one hormone therapy drug on its own
- two hormone therapies together
- hormone therapy with chemotherapy, such as docetaxel
Your doctor will talk to you about which hormone therapy they recommend and for how long you might have take it for.
Outlook For Men With Advanced Prostate Cancer
While it isnt possible to cure advanced prostate cancer, treatments can help keep it under control, often for several years. Treatments will also help manage any symptoms, such as pain.
Some men may not respond well to one treatment, but may respond better to another. And when your first treatment stops working, there are other treatments available to help keep the cancer under control for longer.
Checking Your Hormone Therapy Is Working
Youll have regular blood tests to check the level of a protein called prostate specific antigen . PSA is a protein made by both normal and cancerous prostate cells. It is in the blood in small amounts in all men, unless they have had their prostate gland completely removed.
While the hormone therapy is working, the level of PSA should stay stable or may go down. But if prostate cancer cells are starting to grow and develop, the level of PSA may go up. Then your doctor may need to change your treatment. They will discuss this with you.
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Survival Rates For Prostate Cancer
Survival rates can give you an idea of what percentage of people with the same type and stage of cancer are still alive a certain amount of time after they were diagnosed. These rates cant tell you how long you will live, but they may help give you a better understanding of how likely it is that your treatment will be successful.
Keep in mind that survival rates are estimates and are often based on previous outcomes of large numbers of people who had a specific cancer, but they cant predict what will happen in any particular persons case. These statistics can be confusing and may lead you to have more questions. Talk with your doctor about how these numbers may apply to you, as he or she is familiar with your situation.
What Are The Potential Complications
Prostate cancer and treatment can lead to problems with urination as well as erectile dysfunction.
If stage 2 prostate cancer spreads outside the prostate, it can reach nearby tissues, the lymph system, or bloodstream. From there, it can metastasize to distant sites. Later-stage prostate cancer is difficult to treat and can be life-threatening.
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Adverse Effects And Their Impact On Survival
For most men, ADT has an impact on quality of life, and for some, the adverse effects of ADT are significant enough to cause them to discontinue therapy before completing the recommended length of treatment. Numerous adverse effects result from induced hypogonadism-sexual dysfunction, hot flashes, weight gain, mood lability, sleep disturbance, gynecomastia, shrinkage of genitalia, decrease in bone density, depression, and cognitive decline.
Increased risk of fracture secondary to ADT may also contribute to the survival equation when balancing the risks and benefits of treatment. Androgen suppression has been shown in numerous studies to decrease bone mineral density. ADT for prostate cancer is now one of the leading causes of osteoporosis in this country. Large population-based retrospective series have demonstrated an increased risk of fracture in men who received ADT. Although the cause of increased fracture risk is also due to greater fall risk secondary to metastatic disease and treatment-related frailty, decreased bone density from prolonged androgen suppression is certainly a major contributor. It is well-accepted that hip fractures in the elderly have an impact on survival similarly, aside from the obvious associated morbidity, skeletal fractures in men with prostate cancer have also been shown to increase mortality.
Confirming What Weve Practiced For Years
- What was the grade of the cancer?
- Was it at the edge of the removed prostate gland?
- Was it in the attached seminal vesicles or extending beyond the capsule?
- Was there cancer in any removed lymph nodes?
- What is the trend of serum PSA since surgery?
- How old is the patient, what are his other medical issues, and what are his goals?
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A New Treatment Standard
Still, some men have difficulty tolerating ADT, and not all of them should get it, particularly if theyre older and more likely to die of something other than prostate cancer. Id reserve ADT for younger men with a long life expectancy ahead of them who were diagnosed initially with high-grade or late-stage disease, Thompson said.
This important study confirms that combined therapy is superior to radiation alone and should be viewed as the standard treatment for PSA relapse, said Dr. Marc Garnick, the Gorman Brothers Professor of Medicine at Harvard Medical School and Beth Israel Deaconess Medical Center, and editor in chief of HarvardProstateKnowledge.org. High dose bicalutamide has been associated with cardiovascular side effects, but ongoing and future research is clarifying how best to use ADT in this particular setting.
What Type Of Hormone Therapy Works Best
Unfortunately, understanding the details of hormone therapy for prostate cancer can be difficult. Which drug or combination of drugs works best? In what order should they be tried? Research hasn’t answered these questions yet.
“Right now, there’s a level of art to figuring out which agents to use,” says Durado Brooks, MD, MPH, director of prostate cancer programs at the American Cancer Society. “We don’t have clear evidence yet.”
LHRH agonists remain the usual first treatment. But in some cases, doctors are trying anti-androgens first. Anti-androgens may be especially appealing to younger men who are still sexually active, since these drugs don’t completely shut down sex drive. When anti-androgens stop working — based on PSA tests — a person then might shift onto an LHRH agonist.
Other doctors prefer to begin therapy with a combination of two or even three drugs, especially for patients with symptoms or advanced disease, says Holden.
Researchers originally hoped that combined androgen blockade would significantly add to the benefits of LHRH agonists. However, the results, to date, have been mixed. Some studies have shown slightly longer survival with combined androgen blockade, but the results haven’t been as dramatic as many experts had hoped. Other studies have shown no benefit. A possible explanation may be the type of anti-androgen used, but further studies are needed to answer this question.
What Is Prostate Cancer
The prostate lies below the bladder and in front of the rectum. In men, the size of the prostate increases with increasing age. In younger men, it is about the size of a walnut. Its primary function is to make fluid to nourish the semen.
Growth in the prostate can be of two types
Prostate cancer starts in the prostate gland and may spread to the nearby areas: lymph nodes, organs, or bones in other parts of the body.
Alternative Cares For Prostate Cancer Hormone Treatment For Prostate Cancer Life Expectancy
Prostate cancer is a gravely serious concern for American servicemen. Advance medical research continues, but there are various alternative medications for prostate cancer that should be explored. The the risk of being prostate cancer multiplications yearly and care including chemotherapy and experimental dopes take a charge on the body. Alternative medications for prostate cancer can alleviate some of the negative side effects that accompany traditional medicine options.
The American Cancer Society has provided some appraisals involving prostate cancer in the United States for 2015.
There will be approximately 220,800 new diagnosis of prostate cancer in 2015. Deaths resulting from prostate cancer will reach approximately 27,540. Approximately 1 out of 7 guys will develop prostate cancer in their lifetime.Approximately 6 out of 10 prostate cancer instances include boys over the age of 65, with the average age at diagnosis being 66. The overall health of any person is determined by heredity, the surrounding world, appraise of medical treatment and personal life selections. The US Center for Disease Control and Prevention emphasizes the effects that personal life-style alternatives and attires have on the nation of health for individuals. One of the most significant lifestyle alternatives related to cancer proliferation is the daily intake of a balanced diet or cancer-fighting diet that includes some alternative medicines for prostate cancer.
How To Reduce The Side Effects Of Hormone Therapy For Prostate Cancer
Following hormone therapy, you may become anxious about your sexual functions. Discuss your feelings with your partner and healthcare team.
Lower levels of testosterone will have a negative on your bone density and muscle mass.
Lifestyle changes such as supplementation, exercise, and diet can help you manage this side effect.
You may consider taking calcium and vitamin D supplements. There is a negative relationship between smoking and bone density. Thus, stop smoking after hormone therapy.
Natural ways to help you manage the symptoms of hormone therapy include:
- A healthy diet and appropriate fluid intake to help you maintain a healthy body and mental state.
- Regular exercise help build muscle and bone strength as well as reduce obesity.
- Regular sleeping to help deal with potential fatigue and mental health problems.
Hormone Therapy For Prostate Cancer
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Hormone therapy is also called androgen suppression therapy. The goal is to reduce levels of male hormones, called androgens, in the body, or to stop them from fueling prostate cancer cells.
Androgens stimulate prostate cancer cells to grow. The main androgens in the body are testosterone and dihydrotestosterone . Most androgen is made by the testicles, but the adrenal glands as well as the prostate cancer itself, can also make a fair amount. Lowering androgen levels or stopping them from getting into prostate cancer cells often makes prostate cancers shrink or grow more slowly for a time. But hormone therapy alone does not cure prostate cancer.
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Results Of Treating Prostate Cancer With Radiation Therapy
American Cancer Society. Radiation therapy for prostate cancer. January 2013.
Radiation therapy is best used as an early treatment for a lower-grade cancer that is confined within the prostate gland. The survival rates are similar to the results of radical prostatectomy. Radiation therapy treatments can also be used along with hormone therapy as a first step in treating prostate cancer that has spread outside of the prostate gland to nearby tissues. External beam radiation therapy can be focused on the prostate gland therefore, reducing the radiation exposure to the surrounding healthy tissues. This may increase survival rates over other forms of prostate cancer treatments.
National Cancer Institute at the National Institutes of Health. September 2012
Clinical trials show that external-beam radiation therapy does not seem to improve the survival rate of prostate cancer, but it does help to stop the progression of the disease. One such trial showed an increased progression-free survival at 4 years for patients with a 15% estimated risk of lymph node involvement who received whole-pelvic radiation therapy as compared with prostate-only radiation therapy With this in mind, radiation therapy treatments should be delayed 4 to 6 weeks after a TURP procedure in order to reduce incidence of stricture.
Stevens, G Firth, I. Audit in radiation therapy: long-term survival and cost of treatment. National Institute of Health. Feb. 1997
Diminution Of Muscular Strength
A mans muscular strength is reduced by 12% to 66% as the result of androgen deprivation. Moreover, muscle mass declines by 20% to 30% by age 70 . Because androgen deprivation reduces the amount of protein synthesis and the non-lipid body mass, obesity results. Thus, elderly patients should actively work against the loss of muscle by directed strength-training exercises .
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The Future Of Hormone Therapy For Prostate Cancer
Some experts aren’t sure how much further we can improve hormone therapy for prostate cancer.
“I’m not saying that we’ve reached the end of what we can do with hormonal therapy,” Thrasher tells WebMD, “but there are only so many ways to shut down the hormonal effects. The cancer will still eventually escape.”
Brooks argues that, overall, prostate cancer is only moderately affected by hormones. “You can only do so much manipulating the levels of hormones,” says Brooks. “We have to find better ways to fight the basis of the cancer cells.”
Thrasher and Brooks have more hope that the next breakthroughs will come with different approaches, like chemotherapy or vaccines.
But Holden remains optimistic about the future of hormone therapy for prostate cancer.
“Cancer cells eventually figure out how to survive, how to overcome a specific hormone therapy,” he says. “But if we have enough types of drugs and can keep changing the hormone therapy, we might be able to keep the cancer cells in a state of confusion. We could change therapies before they have a chance to adapt.”
“It’s like an endless chess game,” he says. “You may not ever win, but you might be able to prolong the game indefinitely. I think that hormone therapy still has a lot of promise. We just need to develop better anti-androgens, and more varieties of them.”
How Does Hormone Therapy Work
Hormone therapy for prostate cancer works by either preventing the body from making these androgens or by blocking their effects. Either way, the hormone levels drop, and the cancer’s growth slows.
“Testosterone and other hormones are like fertilizer for cancer cells,” Holden tells WebMD. “If you take them away, the cancer goes into shock, and some of the cells die.”
In 85% to 90% of cases of advanced prostate cancer, hormone therapy can shrink the tumor.
However, hormone therapy for prostate cancer doesn’t work forever. The problem is that not all cancer cells need hormones to grow. Over time, these cells that aren’t reliant on hormones will spread. If this happens, hormone therapy won’t help anymore, and your doctor will need to shift to a different treatment approach.
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