Hormone therapy reduces the body’s natural production of testosterone, the male hormone that ‘feeds’ prostate cancer.
It can be used as a long term treatment to control prostate cancer or before certain types of radiotherapy to shrink the prostate.
There are several types of hormonal therapy. They are given as injections and the most common are: Gosrelin (Zoladex®), Leuporelin (Prostap®) and Triptorelin (Decapeptyl® and Gonapeptyl Depot®).
Treatment is either once a month or every three months, usually given by a GP or Practice Nurse. They can be injected into the skin of the lower abdomen or arm or leg.
Before men start hormonal injections, you will be given a course of tablets called anti-androgens such as Flutamide, Cyproterone Acetate or Biclutamide. These may be given two weeks before hormonal therapy begins and for a short time afterward.
Once started, hormonal therapy will cause a drop in testosterone, leading to a lower PSA level. This happens because the therapy is ‘starving’ the cancer.
Hormonal therapy is very effective at reducing cancerous activity but can cause certain side effects as a result of reducing testosterone levels.
Here is a list of common side effects and some strategies which can help:
| Hormonal Therapy Side Effects | Symptom Management |
|---|---|
| Tiredness | Schedule rest periods in your day. Plan ahead so that you don’t have to rush. Cut out any unnecessary activities and use labour-saving options. |
| Weight gain | Stay active. |
| Hot flushes | Avoid spicy food. Avoid smoking, caffeine and too much alcohol. Wear natural fabrics like cotton. Use natural fabrics for your bedding. Use a fan in your bedroom and carry a handheld fan. Always keep an insulated water bottle full of iced water with you, especially at night. NICE has recommended medication known as medroxyprogesterone and the anti-androgen Cyproterone Acetate to help treat persistent and bothersome hot flushes in men on hormonal therapy. |
| Breast swelling (gynaecomastia) | The drug tamoxifen may help reduce breast swelling and tenderness. It may be possible to have a limited dose of radiotherapy to the breast area. |
| Loss of sex drive (libido) | You can read about this in detail here. |
| Holistic hormonal therapy relief | Meditation, breathing exercises and acupuncture may all help. Up to date information on alternative health treatments from the NHS choices website can be found here. |
Some men on hormone therapy alone and who respond well to treatment may be able to consider intermittent treatment. This is where therapy is stopped when cancerous activity is low and restarted when it increases. Having rest periods from treatment may help men obtain relief from difficult side effects.
Another way of reducing testosterone levels permanently is to have an operation to remove the testicles (called a bilateral orchidectomy).
Deciding the best way to handle prostate cancer risks can be tough. Our support line is staffed by nurses who can help you consider your options. Contact us.
