Hormone Therapy

Candidates: Any man, even those not in good health or with a life expectancy of less than ten more years. Can be used to shrink large prostates prior to radiation treatment; used with radiation treatment for men with cancers likely to spread (Gleason scores 8 to 10) or that have spread locally, and for cancers that have spread distantly to bones or other organs.

Chances of cure: Remote; hormones slow cancer growth but usually do not kill all the cancer cells.

Convenience: Antiandrogens are taken daily as pills; LHRH agonists are given by intramuscular injections every one, three, or four months.

Sexual side effects: Impotence and loss of libido in almost all cases if given long term; effects occur more slowly with antiandrogens alone.

Urinary side effects: None.

Bowel side effects: None.

Other side effects: Hot flashes; breast tenderness and enlargement; osteoporosis, with possible fractures; fatigue; anemia; weight gain; increased cholesterol; short-term worsening of cancer symptoms (flair) when starting on LHRH agonists.

Follow-up treatment if needed: All options open.

Uncertainties: Hormones interfere with PSA levels, so not useful as a marker for cancer progression.

Unknowns: Rate of growth; whether the cancer is continuing to spread.

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