Post-Prostatectomy Hormone Therapy

A prostatectomy involves the removal of part or all of the prostate gland. It is used as a treatment for prostate cancer. Post-surgery, you might receive hormone therapy as part of your treatment regimen. This is a common combination for treating prostate cancer. Your doctor will determine the most appropriate therapy for your situation.

Treatment Goals

• The goal of hormone therapy after a prostatectomy is to slow or prevent the growth of cancer cells that might have been left behind after the operation and to keep new ones from forming. Treatments will either reduce testosterone production or keep your body from absorbing it into cells.

Testosterone-Reducing Therapy

• Hormone therapy that reduces the amount of testosterone produced by your body is known as luteinizing hormone-releasing hormone (LH-RH) agonists. These drugs block chemical messengers that normally signal the testicles to start producing testosterone. They include Lupron, Viadur and Zoladex. You receive injections into the muscle or skin every three to four months. Depending on your circumstances, this treatment can last anywhere from a few months to the rest of your life.

Testosterone-Blocking Therapy

• The other form of hormone therapy interferes with your body's ability to use testosterone. Your adrenal glands produce a small amount of testosterone that cannot be suppressed by LH-RH agonist medications. If you still have part of your prostate after the operation, there is a chance cancerous cells might still exist; these medications keep testosterone from entering these cells and fueling their growth. Casodex and Nilandron are the most commonly used and are taken orally one to three times a day depending on the type.

Removing the Testicles

• Surgical removal of your testicles is considered hormone therapy for prostate cancer. This treatment is performed on an outpatient basis under local anesthesia. While this solution is effective, most men are not comfortable with it and opt for the medications.

Effectiveness

• Initially, hormone therapy can be very effective, but after a few years, the cancer cells eventually adapt and learn to survive without testosterone. The treatment becomes less effective at this point. In order to minimize this resistance, your doctor will monitor your PSA levels throughout treatment. You will stop treatment when they are low and resume the therapy if they rise again. PSA stands for prostate-specific antigen; tests to measure the amount of PSA in your prostate are used as a marker for the presence of cancer.

Side Effects

• Hormone therapy might produce certain side effects. They include breast enlargement, diminished sex drive, impotence, hot flashes, weight gain, loss of muscle and bone mass, nausea, diarrhea, fatigue and liver damage. You are at an increased risk of heart attack during the first two years of treatment so your doctor will carefully monitor your health and treat any factors that increase your risk for heart attack, such as high blood pressure or high cholesterol.