Hormone Therapy for Prostate Cancer
Hormone therapy is frequently used together with radiotherapy in the treatment of prostate cancer. You may be started on hormonal treatment to stop the production or block the action of testosterone before external beam radiotherapy.
The duration of the treatment will depend on the stage of your cancer and is usually started three months before starting external beam radiotherapy. Patients with locally advanced prostate cancer may need to take the hormones for up to three years.
The main benefits of hormonal treatment are:
- To reduce the size of the prostate gland and the cancer which in turn reduce the radiation fields and the side-effects.
- Hormones combined with radiotherapy have been shown to increase the cure rates in patients with the more aggressive forms of prostate cancer and in cases where the cancer has spread to the area just outside the gland.
Hormones can either be given as a daily tablet to block the action of testosterone or as an injection, known as LHRH-analogue, that produce a reversible castration. The main side effects of hormonal treatments include hot flushes, loss of sexual desire. They can occasionally cause impotence, breast tenderness and enlargement.
Evidence for hormone therapy for prostate cancer
The addition of radiation therapy to hormone therapy for the treatment of locally advanced prostate cancer reduces prostate cancer deaths by 50%, according to the results of a Scandinavian study published in the Lancet.
In 1996 researchers from the Scandinavian Prostate Cancer Group and the Swedish Association for Urological Oncology initiated a Phase III trial to evaluate the benefits of adding radiation to hormone therapy. The trial involved 875 patients who were randomized to receive either hormone therapy alone (439) or combined hormone/radiation therapy (436). After nearly eight years of follow-up, 79 men in the hormone-only group had died of prostate cancer compared with 37 in the combination group. Furthermore, the rate of recurrence was substantially higher in the hormone-only group: 74.7% versus 25.9% in the combination group. After five years urinary, rectal, and sexual problems were slightly more frequent in the combination group.
The researchers concluded that the combination of radiation therapy and hormone therapy was superior to hormone therapy alone and cut the rate of prostate cancer deaths in half. Furthermore, the side-effect profile for the combination therapy was acceptable.
The Birmingham Prostate Clinic is a centre of excellence for external beam radiotherapy and we would be happy to discuss your needs and treatment options with you.