Side Effects Of Prostate Cancer Androgen Hormone Therapy
Antiandrogens are medications such as flutamide, bicalutamide, nilutamide, and cyproterone acetate which directly block the actions of testosterone and DHT within prostate cancer cells. They are a form of hormonal therapy which, in the treatment of prostate cancer, makes use of such medications (otherwise orchiectomy) to block prostate cancer cells from getting the dihydrotestosterone (DHT) hormone that is required for their growth and spread.
This way these androgen treatments cause the tumor to stop growing and even shrink. Although they rarely cure the disease (since the cancers generally become resistant after a while), they are a good way to slow the disease down, especially when it is metastasizing.
Prostate cancer hormone therapy is also called androgen deprivation therapy (ADT) or androgen suppression therapy because of this. The androgens, produced mainly in the testicles, stimulate prostate cancer cells to grow; and as stated in the previous chapter, lowering their levels in the patient often causes the cancer shrink or grow more slowly.
The side effects prostate cancer androgen hormone therapy are pretty much the same as those that are experienced if the patient had to undergo an orchiectomy (surgical removal of the testicles to hinder testosterone production). There isn’t as much of the psychological impact of surgery, but the hot flashes are there just the same. It is common for such a patient to begin to experience weight gain and loss of libido within a year or more of the treatment, while in some people it doesn’t even take that long.
One of the most common side effects of androgen deprivation therapy is the enlargement of the breasts (gynecomastia), a source of considerable embarrassment to most men. Also, perhaps the most devastating complication, impotence can make a man desire not to want to continue living; and osteoporosis, a bone condition characterized by a decrease in density, which also results in the bones being porous and more easily fractured than normal bones.
GnRH (gonadotropine releasing hormone) agonists may also cause increased bone pain from metastatic cancer, and certain estrogens may even increase the risk for cardiovascular disease and blood clots. Ketoconazole specifically has been known to bear with it a certain risk of liver damage to the patient, especially with prolonged use; and another drug, aminoglutethimide, has been known to cause skin rashes. For this reason, the doctor has to be fully apprised of the patient’s medical history before administering such treatments.
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