Alternatives to Hormone Therapy for Men With Prostate Cancer
Hormone therapy (androgen deprivation therapy or ADT) is an effective treatment option for some men with prostate cancer. This approach may reduce symptoms, slow the progression of their disease, and even extend their lives.
A blood test called the prostate-specific antigen (PSA) test can tell your doctor when to begin hormone therapy. Additionally, this test checks for any irregularities in your digital rectal exam or signs of prostate cancer cells that have spread outside the gland.
Most people with prostate cancer respond well to hormone therapy and the tumor shrinks or dies. However, some may experience a “flare,” in which their cancer’s growth accelerates temporarily due to an initial spike in testosterone levels before those levels return. This can cause the prostate gland to enlarge and make urinating difficult.
The primary disadvantage to hormone therapy is the potential side effects. These could include loss of sex drive, hot flashes, breast development (gynecomastia), weight gain and reduced levels of “good” cholesterol. Other potential negative outcomes from hormone therapy include bone thinning and low estrogens which could lead to osteoporosis or fractures.
Alternative treatments to hormone therapy exist and some of them are more effective than the most widely prescribed remedy. Some of these alternatives require different medications or require surgery, radiation or chemotherapy in order to address cancer.
*Abiraterone — Abiraterone is a medication that inhibits androgen production by the prostate, testes, and adrenal glands. It may be taken alone or combined with ADT treatment; studies have demonstrated its potential to extend survival for men with advanced prostate cancer who aren’t responding to ADT and may enhance its effectiveness in preventing metastatic disease as well.
It is essential to remember that abiraterone can have serious side effects, including fluid retention, low blood potassium levels and liver problems. Furthermore, this drug has an addictive nature; therefore, those with kidney issues or taking drugs which affect blood pressure should not take it long-term.
An alternative option is a chemical that prevents testosterone production in the testicles, known as luteinizing hormone-releasing hormone agonists or LHRH agonists. These are injected into the testicles every one to four months and may cause severe side effects but they will clear up once you stop taking the medication.
This method is not suitable for everyone and surgery (orchidectomy) is the only option if you want to proceed. It would be wise to discuss the potential advantages and potential risks with your healthcare provider prior to undergoing this method.
Intermittent hormone therapy is being investigated to see if it can be beneficial in certain circumstances. This treatment entails stopping and starting hormone therapy for several months at a time, then restarting once your PSA level drops below a specific number.
Some researchers are exploring intermittent therapy for men who experience recurrences of their cancer. It has been suggested that men may benefit more if they alternate between ADT and chemotherapy treatments.