What is Androgen Deprivation Therapy(ADT)?
Urology Of Greater Atlanta
What Does Androgen Deprivation Therapy Do?
Androgen suppression therapy, a type of hormone therapy is used to reduce levels of male hormones, called androgens, in the body, or to stop them from stimulating the growth of prostate cancer cells.
The two main androgens in the body are testosterone and dihydrotestosterone (DHT). The testicles are the largest producers of androgen, however the adrenal glands (glands that sit above your kidneys) as well as the prostate cancer itself, also makes a considerably large amount too. When androgen production is reduced or stopped from getting into prostate cancer cells, this often makes prostate cancers shrink or grow more slowly for a time. It should be noted, however, that hormone therapy alone does not cure prostate cancer.
After a positive diagnosis and the staging process, your doctors will know how best to treat the cancer using the various treatment options available such as hormone therapy or radiotherapy brachytherapy (seeds) with or without external beam radiation.
What Are The Different Types of Hormone Therapy for Prostate Cancer?
Surgical Castration (known as Orchiectomy)
This is a form of hormone therapy because of its effect. As the testicles are the largest producers of androgens (such as testosterone) when they are removed the androgens will be significantly reduced. This usually will stop the prostate cancer from growing or may even cause them to shrink for some time.
The effects are permanent and many men find it difficult to accept so treatment with drugs to lower hormone levels is usually preferred.
Luteinizing hormone-releasing hormone (LHRH) agonists (also called LHRH analogs or GnRH agonists) are used to lower the amount of testosterone made by the testicles. This type of treatment is sometimes referred to as a medical castration because they lower androgen levels just as well as orchiectomy.
LHRH agonists are injected or placed as small implants under the skin. At Urology of Greater Atlanta, the urologists use Triptorelin (Trelstar).
LHRH antagonists are a good option when treating advanced prostate cancer. This treatment also lowers testosterone levels but does so more quickly and doesn’t cause tumor flare as the LHRH agonists do. Their function is slightly different in how they work too. Treatment with these drugs can also be considered a form of medical castration.
- Degarelix (Firmagon) is given as a monthly injection under the skin. Some men may notice problems at the injection site (pain, redness, and swelling).
- Relugolix (Orgovyx) is taken as pills, once a day, so it might allow for less frequent office visits.
How Long Does Androgen Deprivation Therapy Last?
Depending on the drug used, they are given anywhere from once a month up to once a year.
What Are The Side Effects of ADT for Prostate Cancer?
As all the above treatments have the same effect of lowering the levels of hormones such as testosterone, all will produce similar side effects. These side effects of hormone therapy can include:
- Reduction or loss of sexual desire
- Erectile dysfunction (impotence)
- Shrinkage of testicles and penis
- Hot flashes, which may get better or go away with time
- Gynecomastia (Breast tenderness and growth of breast tissue)
- Osteoporosis (bone loss), which can lead to broken bones
- Anemia (lower count of red blood cells)
- Decreased mental sharpness
- Loss of muscle mass
- Weight gain
- Increased cholesterol levels
Men with prostate cancer that would like to be treated with ATD can get in contact with the urologists at Urology of Greater Atlanta. Call or make an appointment today.