Written by Bernie Riley, PCFA General Manager of Supportive Care Programs
What is hormone therapy?
Hormone therapy, otherwise known as Androgen Deprivation Therapy (ADT), is a group of medicines used to reduce the male sex hormone (androgens) testosterone and commonly used to treat prostate cancer.
Testosterone is important for the development of male sexual organs, including the prostate, and libido (or sex drive) and other masculine features like an increased muscle and bone mass and body hair. Most of this testosterone is produced in the testes and a smaller proportion in the adrenal glands which sit above the kidneys.
In men with prostate cancer, testosterone also causes prostate cancer cells to grow and spread, and so depriving prostate cancer cells of testosterone is important to slow growth and reducing risk of cancer spreading and reduce some symptoms caused by the cancer. Hormone therapy may also over a number of weeks reduce your PSA levels and offer long term control of the cancer by limiting the amount of testosterone available to prostate cancer cells wherever they are in the body.
People seeking any further information could call PCFA's Telenursing Service on 1800 22 00 99 to chat with the team about their options. We're here to help!
There are different types of hormone therapy:
- Luteinizing hormone-releasing hormone agonists (LHRH agonists) LHRH agonists trick the body into stopping production of its own LHRH, causing the testicles to stop producing testosterone. Examples of LHRH agonist medications include Eligard®, Lucrin®, Zoladex® and Diphereline®.
- LHRH antagonists reduce testosterone production by blocking the messages from the pituitary gland to the testicles. The drug Firmagon® or Degarelix is a LHRH antagonist
- Anti-androgens -Anti-androgen medicines are a type of hormone therapy that works by blocking the action of testosterone on the prostate cancer cells. For example: Bicalutamide (Cosudex®) , Cyproterone acetate (Androcur®) or Nilutamide (Anandron®).
- Novel Hormonal agents- also work to reduce the ability of prostate cancer cells to grow and spread through several different mechanism. Eg Abiraterone acetate (Zytiga ®), Darolutamide (NUBEQA®) or Apalutamide (Eryland®) and Enzalutamide (Xtandi ®).
Many men with prostate cancer may be on one or a combination of hormone therapy, delivered in oral and/or injection form.
It's important that you speak with your urologist or treating doctor about what options you are eligible for.
What are the side effects?
Men on hormone therapy may experience a wide range of side effects. Sometimes these can be minor or for other men, they may be more frequent and distressing.
Common possible side effects are:
- Loss of libido or sex drive.
- Erection problems.
- Hot flushes and night sweats.
- Fatigue (tiredness).
- Weight gain from increased body fat.
- Declining bone density (osteoporosis).
- Loss of muscle mass and muscle weakness.
- Depression or mood swings.
- Poor memory, concentration and physical unsteadiness.
- Breast swelling and breast tenderness and genital shrinkage
- Increased risk of cardiovascular disease and diabetes.
After stopping hormone therapy, some side effects may diminish with time, but sometimes the side effects never go away.
Recovery from hormone therapy side effects after stopping treatment will depend on your age, the type of hormone therapy you were on, whether you were on a short course of hormone therapy over a few months or a longer course over several years, and whether the hormone therapy was continuous or intermittent.
How can I manage side effects I'm experiencing?
The good news is, there is support available and ways that you can reduce the impact of many side effects. PCFA's Telenursing team is here to support you through it. We've provided some tips for the most common side effects, and some ideas for improve general physical health and wellbeing.
If you need support, please reach out to PCFA's Telenurses on 1800 22 00 99. We can also provide a referral to PCFA's Counselling Service.
Loss of libido and sex drive
For some men, hormone can result in tiredness, reduced energy and changes in your physical appearance such as weight gain, and/or shrinkage of your testicles. All of these things can result in reduction or loss of sexual desire. As a result, some men experience lower confidence and self-esteem, which can also impact relationships. To help navigate any changes to your sex drive, it's important to talk about it. Don't go through it alone. You can chat with your healthcare team, or with a psychologist or sex therapist/counsellor (including PCFA's Counselling Team).
Erectile dysfunction
