Hormone therapy for prostate cancer

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Your doctor has told you that you may benefit from hormone treatment for your prostate cancer. Hormones are naturally occurring substances, often referred to as the body’s chemical messengers.

Testosterone is the male sex hormone; it is produced by the testicles and is involved in a number of functions including stimulating sex drive. However cancer of the prostate depends on testosterone for its growth. Hormone therapy aims to reduce the production of testosterone to slow down or stop the growth of cancer cells.

You may receive hormone therapy in the following ways:

Injections given monthly, every three months, or six monthly.
Tablets.
In certain circumstances some men may opt for an operation to remove the testicles.
The length of time you may remain on hormone therapy could vary from six months to three years.
Hormones are started before the radiotherapy and should be continued during it.

Although the treatments have similar effects and similar side-effects they work in slightly different ways.

Side-effects

These will vary depending on the type of treatment you are having, your doctor or nurse will be able to tell you about the specific side-effects related to your particular treatment.

Please note; you are unlikely to experience all of the side-effects mentioned. We have only listed the more commonly experienced side-effects. You will receive further information with your supply of medication.

Some of the more common side-effects you may experience are:

Impotence – The inability to have or maintain an erection and loss of sexual desire. If the hormone treatment is stopped the problem may resolve but this will take some time. There are various treatments for impotence that may be helpful, your doctor or nurse will be able to advise you. You might notice a change in the size of your penis and a change in shape and size of your testicles.

Weight gain – Hormone treatment may make you gain weight. Exercise can help to keep your weight stable. It is also advisable to eat a well-balanced diet and reduce your normal portion size.

Tiredness – Hormone treatment may make you feel tired. Try pacing your activities so that you can rest as required. Try and do a little every day as doing nothing can make you feel more tired.

Psychological effects – Hormone treatment may make you feel emotional, anxious and tearful without really knowing why. You may find it helpful to talk this through with your doctor or nurse.

Breast swelling/tenderness – Some hormone treatments may cause breast swelling and/or tenderness. If breast tenderness or swelling is causing you a problem please talk to your doctor or nurse about possible treatments for this.

Hot flushes – A number of the hormonal treatments used in prostate cancer can cause hot flushes. Although it is not always possible to stop the hot flushes, the following simple measures overleaf, may help to reduce the flushing:

Reduce the amount of drinks containing caffeine you have per day.
Reduce alcohol and nicotine intake.
Take lukewarm baths and showers as they are less likely to trigger sweats than hot ones.
Wear cotton clothing, especially at night.
Use light bed sheets rather than duvets.
Some people find that taking Evening Primrose oil, Sage supplements and auricular acupuncture may be helpful although there is no scientific evidence to back this up. Ask a member of team if you need more information.

If you are experiencing severe hot flushes please inform your doctor or nurse. You may be prescribed a short course of tablets to help with this side-effect.

Bone strength – This can be affected by hormones. Maintaining a healthy diet and doing regular exercise can help prevent weight gain and osteoporosis (weakened bones). For patients having hormone injections for longer than one year, we would also suggest taking Calcium and Vitamin D supplements and Alendronic Acid in selected cases.

Heart problems – Hormone treatment can increase your risk of heart disease by a small amount. Maintaining a healthy diet and doing regular exercise can help to reduce your risk.

Sleep disturbances – You might notice changes in your sleep pattern, i.e. waking up frequently at night and finding it difficult to fall back to sleep. A cool room, relaxing music, mindfulness and avoiding stimulants like caffeine and iPad/phone screens prior to bed time might be helpful.

Other possible side-effects include:

Headaches, skin rash/irritation, dry mouth, heartburn, nausea, constipation, diarrhoea, dizziness, shortness of breath, changes to memory or concentration, hair loss, reduction in muscle mass/strength, risk of diabetes mellitus.