What You Need To Know About The Prostate Hormone Therapy Prostate Cancer Drug Names
A enlarged prostate can also cause blockages in the urethra. A blocked urethra can also damage the kidneys. A patient suffering from an enlargement of the prostate may have pain in his lower abdomen and genitals. If pain is present, a digital rectal examination will reveal hard areas. A doctor may prescribe surgery or perform an endoscopic procedure. If the enlarged prostate is not completely removed, it will shrink.
While the size of an enlarged prostate will influence the extent of urinary symptoms, men may experience a range of urinary symptoms. Some men have minimal or no symptoms at all. Some men will have a very enlarged prostate, whereas others will have a mild enlargement. Generally, the symptoms can stabilize over time. Some men may have an enlarged prostate but not notice it. If they have an enlarged colon, their physician can perform a TURP procedure.
Hormone Therapy Can Cause Side Effects
Because hormone therapy blocks your bodys ability to produce hormones or interferes with how hormones behave, it can cause unwanted side effects. The side effects you have will depend on the type of hormone therapy you receive and how your body responds to it. People respond differently to the same treatment, so not everyone gets the same side effects. Some side effects also differ if you are a man or a woman.
Some common side effects for men who receive hormone therapy for prostate cancer include:
How Hormone Therapy Is Given
Hormone therapy may be given in many ways:
- Oral. Hormone therapy comes in pills that you swallow.
- Injection. The hormone therapy is given by a shot in a muscle in your arm, thigh, or hip, or right under the skin in the fatty part of your arm, leg, or belly.
- Surgery. You may have surgery to remove organs that produce hormones. In women, the ovaries are removed. In men, the testicles are removed.
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How Are Hormone Therapy Medicines Used
Hormone therapy medicines may be used alone, with another type of hormone therapy, or with another type of prostate cancer treatment.
Monotherapy
Monotherapy is when only one type of hormone therapy medicine is used to lower the amount of testosterone in your body. Monotherapy can be effective in shrinking a prostate cancer tumor, slowing the spread of your prostate cancer, and relieving pain caused by your prostate cancer. Monotherapy may be used with neoadjuvant therapy or adjuvant therapy. Please read When is Hormone Therapy Used for Prostate Cancer? to learn more about neoadjuvant and adjuvant therapy.
Combination therapy
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What Is Intermittent Adt
Researchers have investigated whether a technique called intermittent androgen deprivation can delay the development of hormone resistance. With intermittent androgen deprivation, hormone therapy is given in cycles with breaks between drug administrations, rather than continuously. An additional potential benefit of this approach is that the temporary break from the side effects of hormone therapy may improve a mans quality of life.
Randomized clinical trials have shown similar overall survival with continuous ADT or intermittent ADT among men with metastatic or recurrent prostate cancer, with a reduction in some side effects for intermittent ADT .
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What Should You Ask Your Doctor About Treatments
The American Cancer Society recommends that you ask questions like these:
- What treatment might be best for me?
- What are the possible benefits of getting it?
- How soon would I need to start treatment?
- Will I need to get surgery as part of my treatment? If so, what will it be like and who will do it?
- Will I need other treatments, too? If so, how might they benefit me?
- What side effects could my treatments cause? And what should I do if I get them?
- Is there a clinical trial that might be a good option for me?
- Can you review any vitamins or diet Iââ¬â¢m on to make sure it wonââ¬â¢t interfere with my cancer treatment?
Kinds Of Hormone Therapy
Hormone therapy is a category encompassing a number of treatments. In some conditions or diseases, certain hormones are prescribed in order to increase their levels. This is frequently referred to as hormone replacement therapy . Hormones can be natural or synthetic, meaning produced commercially . Patients who do not have prostate cancer but have symptoms from low testosterone levels, such as fatigue, may be prescribed testosterone as a type of HRT. In certain cases, patients with prostate cancer under control may receive this type of hormone therapy however, because of the risk of activating the cancer, some doctors advise against it. Male children or adults with hypogonadism are prescribed testosterone as HRT.
As mentioned previously, HT in prostate cancer aims to reduce production of the hormone testosterone, rather than increase it, thereby interfering with cancer cells ability to use it to grow.
The hormone therapies that have become standard prostate cancer treatments are the ones we discuss in detail in this guide. All decisions regarding these treatments should be carefully made by the patient and doctor together.
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How Much Hormone Therapy Costs
The cost of hormone therapy depends on
- the types of hormone therapy you receive
- how long and how often you receive hormone therapy
- the part of the country where you live
Talk with your health insurance company about what services it will pay for. Most insurance plans pay for hormone therapy for their members. To learn more, talk with the business office where you go for treatment. You can also go to the National Cancer Institute database, Organizations that Offer Support Services and search financial assistance. Or call toll-free 1-800-4-CANCER to ask for help.
What Is Hormone Therapy
Hormones occur naturally in your body. They control the growth and activity of normal cells. Testosterone is a male hormone mainly made by the testicles.
Prostate cancer usually depends on testosterone to grow. Hormone therapy blocks or lowers the amount of testosterone in the body.
Hormone therapy on its own doesn’t cure prostate cancer. But it can lower the risk of an early prostate cancer coming back when you have it with other treatments. Or it can shrink an advanced prostate cancer or slow its growth.
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How The Study Was Performed
During the study, scientists randomized 1,071 men with intermediate- or high-risk localized prostate cancer into four groups. One group received radiation and six months of an anti-testosterone drug called leuporelin, and the second group received radiation plus 18 months of leuporelin therapy. Two other groups were treated with the same regimens of either radiation plus six or 18 months of leuporelin therapy, along with another drug called zoledronic acid, which helps to limit skeletal pain and related complications should cancer spread to the bones. Study enrollment occurred between 2003 and 2007 at 23 treatment centers across New Zealand and Australia.
How Is Benign Prostatic Hyperplasia Treated
If you have mild symptoms, you may not require any treatment. Your healthcare provider may recommend a watchful waiting approach in which you schedule regular appointments to ensure your BPH doesnt get any worse.
Treatment options include:
Medications
The most commonly prescribed medications relax the muscle in your prostate, which reduces tension on your urethra. Examples include:
Some medications decrease the production of the hormone DHT, which can slow the growth of your prostate gland. These medications are most beneficial to people with larger prostates. Examples include:
Your healthcare provider may prescribe combined medications that help treat your symptoms as well as improve your urine flow. One example is dutasteride and tamsulosin .
After you start a medication, it may take between one and eight weeks for your symptoms to improve.
Surgery
Several different types of surgery can remove prostate tissue that blocks your urethra. These include:
After a surgical procedure, you should be able to resume normal activities within a few days or a week.
Minimally invasive treatments
Examples of minimally invasive treatments include:
The most common side effects of these treatments include peeing more than normal and discomfort or irritation while your prostate heals.
After a minimally invasive procedure, you should be able to return to your normal activities in a few days. You should see improvements in your symptoms within three to six weeks.
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Hormonal Therapy On Its Own
Doctors do not usually advise having hormonal therapy instead of a prostatectomy or radiotherapy. Hormonal therapy alone cannot cure early or locally-advanced prostate cancer.
Depending on your general health and preferences, you may decide to have hormonal therapy on its own. For example, if you:
- are not well enough to have a prostatectomy or radiotherapy
- do not want to have a prostatectomy or radiotherapy
- are monitoring prostate cancer, for example having watchful waiting and the cancer starts to grow.
Hormonal therapy can slow down or stop the cancer cells growing for many years. It can also improve any symptoms. Not having surgery or radiotherapy means you avoid the side effects of these treatments. But hormonal therapy also causes side effects. It is important to talk to your doctor or nurse before you decide.
How Is Benign Prostate Enlargement Diagnosed
If your GP suspects that you have an enlarged prostate, you’ll be asked to complete a questionnaire to assess your symptoms.
Each question has five possible answers that carry a score, and your overall score indicates the severity of your symptoms.
Your GP will also want to rule out other conditions that cause similar symptoms to prostate enlargement.
You may have a number of standard tests, such as urine tests, plus some more specific tests, such as a blood test that measures PSA.
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What Are The Side Effects Of Hormone Therapy For Prostate Cancer
Because androgens affect many other organs besides the prostate, ADT can have a wide range of side effects , including:
- loss of interest in sex
Studer UE, Whelan P, Albrecht W, et al. Immediate or deferred androgen deprivation for patients with prostate cancer not suitable for local treatment with curative intent: European Organisation for Research and Treatment of Cancer Trial 30891. Journal of Clinical Oncology 2006 24:18681876.
Zelefsky MJ, Eastham JA, Sartor AO. Castration-Resistant Prostate Cancer. In: Vincent T. DeVita J, Lawrence TS, Rosenberg SA, eds. DeVita, Hellman, and Rosenberg’s Cancer: Principles & Practice of Oncology, 9e. Philadelphia, PA: Lippincott Williams & Wilkins 2011.
Smith MR, Saad F, Chowdhury S, et al. Apalutamide and overall survival in prostate cancer. European Urology 2021 79:150158.
What Is An Enlarged Prostate
Many men will experience an enlarged prostate in their lifetime. Learn about the symptoms of an enlarged prostate, what causes it, and how to treat an enlarged prostate here.By the time you reach the age of 60, you have a 50/50 chance of having an enlarged prostate. When you blow out 85 candles on the birthday cake, the likelihood increases to 90%.
You might be wondering, If its so common, whats the big deal about having benign prostatic hyperplasia ?
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When Is Hormone Therapy Used
Hormone therapy may be used:
- If the cancer has spread too far to be cured by surgery or radiation, or if you cant have these treatments for some other reason
- If the cancer remains or comes back after treatment with surgery or radiation therapy
- Along with radiation therapy as the initial treatment, if you are at higher risk of the cancer coming back after treatment
- Before radiation to try to shrink the cancer to make treatment more effective
How Can I Reduce My Risk Of Developing Benign Prostatic Hyperplasia
The best ways to reduce your risk of developing BPH are to make lifestyle changes that improve your prostate and heart health and take supplements.
Exercising at least 30 minutes each day may help prevent BPH or slow prostate growth. Maintaining normal cholesterol, blood pressure and blood sugar levels is also important.
The following herbal supplements may also help reduce your risk of developing BPH:
- Beta-sitosterol. Beta-sitosterol is a micronutrient in plants that may help keep your heart healthy.
- Pygeum africanum. Pygeum africanum is an herbal extract from African cherry tree bark that may help shrink your prostate.
- Flaxseed. Flax is a good source of dietary fiber and omega-3 fatty acids that may help lower your cholesterol.
- Pumpkin seed oil. Pumpkin seed oil comes from pumpkin seeds. It may help shrink your prostate.
Talk to your healthcare provider before taking any new supplements. They may adversely react to other supplements or medications youre currently taking.
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How Is Benign Prostatic Hyperplasia Diagnosed
Your healthcare provider will review your medical history, ask you questions and perform a physical examination. Part of the physical exam involves a digital rectal exam.
During a digital rectal exam, your healthcare provider will carefully insert their gloved digit into your rectum. Theyll feel the edges and surface of your prostate, estimate the size of your prostate and detect any hard areas that could be cancer.
Your healthcare provider may also order:
- A survey to evaluate the severity of your symptoms.
- A urine flow test to measure the speed of your pee stream.
- A study to detect how much pee remains in your bladder after youve finished peeing.
- A cystoscopy to look into your bladder.
Surgical Treatment For Enlarged Prostate
- Transurethral resection of the prostate . In this surgery, the inner portion of the prostate is removed. Used 90% of the time, this is the most commonly used surgical procedure for BPH.
- Open prostatectomy . The surgeon makes an incision and removes the enlarged tissue from the prostate.
- Laser surgery Laser surgery uses laser energy to destroy prostate tissue and shrink the prostate.
- Transurethral incision of the prostate . This surgery does not involve removing prostate tissue. A few small cuts are made in the prostate gland to reduce the prostates pressure on the urethra, making urination easier.
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Minimally Invasive Procedures For Bph
When BPH symptoms range from moderate to severe and medications aren’t effective, minimally invasive procedures may provide relief. Some surgeries of this nature involve removal of the outer part of the prostate and cuts within this gland, while others use microwaves and radio waves to remove tissues.
Hormone Therapy With Radiotherapy
You have this if:
- your cancer hasnt spread to other parts of the body but is at a high risk of coming back, eg the cancer has grown through the covering of your prostate
- you have a very high prostatic specific antigen level
- you have a high Gleason score
You might have hormone therapy before, during and after radiotherapy. Doctors usually recommend that you have the treatment for between 3 months and 3 years. How long depends on the risk of your cancer coming back and how many side effects you get.
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Paracrine And Autocrine Signaling
Newer treatments for prostate disease have been based on regulating paracrine signaling within the tissue itself.
Paracrine signaling and mesenchymalepithelial cell interactions are an essential component of androgenic control of the prostate gland and AAT can also be effectively realized by targeting local androgen metabolism and signaling. Testicular testosterone is normally converted to the more potent androgen dihydrotestosterone by the 5-reductase type 2 enzyme that is located in the prostatic stroma. DHT then acts in a paracrine manner to subsequently activate the epithelial androgen receptor to maintain secretory function. Treatment with 5R inhibitors rapidly reduces DHT levels within the prostate, while AR antagonists effectively prevent any androgenic effects by blocking the androgen signaling pathway.
In a manner analogous, yet different, to androgens, estrogens also exert local effects in the prostate via paracrine mechanisms. An important difference is that estrogens are both adversely and beneficially implicated in the genesis and progression of PCa. This alters the application and complicates the use of estrogen-based therapies in the treatment of prostate disease.
The Suitability Of Patients Over Age 70 For Hormonal Therapy
It is agreed by all that hormonal therapy is indicated for an increasing percentage of patients with increasing age, but the only entirely uncontroversial indication for it is symptomatic, metastatic prostate cancer . Irritative and obstructive urinary symptoms can also be treated hormonally .
The patients chronological age is less important than his biological age and life expectancy. In one study, the tumor-specific survival rates of patients with local prostate cancer were no different at age 60 and at age 80 if the patients were given hormonal treatment only in case of progression of their prostate cancer. In this age group, it was the Gleason scorea tumor-associated, rather than patient-associated, factorthat shortened metastasis-free 10-year survival: The figure for highly differentiated prostate cancer was 81%, while that for poorly differentiated prostate cancer was 26% .
The case studies mentioned above yielded survival figures based on the patients chronological age. One may suspect, however, that the treating physicians were also influenced by their patients comorbidities when choosing the therapy to be given to each. In a population-based study in the Netherlands, only 8% of the patients under age 69 had two or more comorbidities, as compared to 27% of patients aged 80 .
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What Types Of Hormone Therapy Are There
There are three main ways to have hormone therapy for prostate cancer. These are:
- injections or implants
- surgery to remove the testicles .
The type of hormone therapy you have will depend on whether your cancer has spread, any other treatments youre having, and your own personal choice. You may have more than one type of hormone therapy at the same time.