Why isn't hormone therapy used in all prostate cancers?

Posted by upnort @upnort, Feb 15, 2022

An observation and insightful comment by one group member here: "Lupron/Eligard both shrink the prostate and stops the production of testosterone which feeds the growth of prostate cancer." If so, why don't all treatment options of prostate cancer include hormone therapy? I am waiting on a second opinion for my treatment (Lupron + EBRT) from Mayo hoping I can do without the often dreaded side effects of hormone therapy. I realize one size doesn't fit all, but why is hormone therapy used in some prostate cancers and not in others?

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Because of the side effects would be the simple answer. I know because I’ve been on it intermittently throughout the different treatments I have. Tiredness,weakness,sex drive,ED,bone loss,weight gain. So when a person has a low grade cancer or they catch it early enough it can sometimes be cured or controlled without the hormone therapy.

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Can anyone tell me what hormone therapy does to you mentally? My Dad had a shot in July and hasn't acted right since. Gets mean,cusses my mom and gets very angry with her,makes rude sexual comments to women and even started running around outside in the nude this past summer. This all started after he had the hormone shot. He acts very odd. Thank you for any help.

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I was told by my friend that he is getting Hormone treatment because his Cancer was advanced with a high Gleason Score. He has found his emotional stability has suffered from this program. He now takes anti depressants and has anxiety. .it has been 2 yrs of treatments. My husband had Robotic Prostate Surgery 8 years ago ( by a Doctor who had done 900 of these surgeries) because he didn’t want to deal with 2.5 years of treatments Stanford recommended. He is now 75 yrs old and continues being tested annually and is free of Cancer. He had his sexual functioning back after 18 months with the help of Cialis. Do your own research and get opinions from different Doctors.

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@international9370

Can anyone tell me what hormone therapy does to you mentally? My Dad had a shot in July and hasn't acted right since. Gets mean,cusses my mom and gets very angry with her,makes rude sexual comments to women and even started running around outside in the nude this past summer. This all started after he had the hormone shot. He acts very odd. Thank you for any help.

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Some, not all, experience depression and cognitive side affects with ADT

Sounds like your father is one of those.

Considering seeing if he is willing to see a psychiatrist for an assessment and possibly medication.

I don't know his lifestyle but here's an article on how exercise can help. He could consider a gym membership and perhaps a trainer to initially help him develop a program that works for him specifically.
https://www.urotoday.com/video-lectures/apccc-2022/video/mediaitem/2648-depression-bone-health-and-exercise-in-prostate-cancer-fred-saad-tomasz-beer-charles-ryan.html
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5885282/
Kevin

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Surgery alone is not enough if the cancer has already metastasized to the bone.

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@mercuryrose

I was told by my friend that he is getting Hormone treatment because his Cancer was advanced with a high Gleason Score. He has found his emotional stability has suffered from this program. He now takes anti depressants and has anxiety. .it has been 2 yrs of treatments. My husband had Robotic Prostate Surgery 8 years ago ( by a Doctor who had done 900 of these surgeries) because he didn’t want to deal with 2.5 years of treatments Stanford recommended. He is now 75 yrs old and continues being tested annually and is free of Cancer. He had his sexual functioning back after 18 months with the help of Cialis. Do your own research and get opinions from different Doctors.

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Wow!

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@mercuryrose

I was told by my friend that he is getting Hormone treatment because his Cancer was advanced with a high Gleason Score. He has found his emotional stability has suffered from this program. He now takes anti depressants and has anxiety. .it has been 2 yrs of treatments. My husband had Robotic Prostate Surgery 8 years ago ( by a Doctor who had done 900 of these surgeries) because he didn’t want to deal with 2.5 years of treatments Stanford recommended. He is now 75 yrs old and continues being tested annually and is free of Cancer. He had his sexual functioning back after 18 months with the help of Cialis. Do your own research and get opinions from different Doctors.

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That's great to hear. Congrats. I had my surgery in August this year.

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This is so strange. About a decade ago I was rubbing androgel into my body on a daily basis and I felt like Superman … eh, that may be a bit much. Probably more like Ben Afflack's Batman. Then I aged out of the Medicaid program and Medicare would not cover the androgel so I simply forgot about it. I began to put on weight and didn't have the energy to exercise. Then 2 years ago I raised the subject with my new primary care doctor. She sent me to the local Quest office for a blood test and one of the findings was that my testosterone levels were really low. So she referred me to a Urologist who had me go back to Quest for another blood test. When he got the results back he talked to me a bit about what Medicare would cover and I began going to his office where one of the nurses shot me up with some form of supplemental testosterone once every 3 weeks. This started in the Fall 2 years ago. After the Christmas holidays passed I told the doctor that I saw no change at all in my body. Off to Quest again and it was then that I began to hear the letters PSA with numbers atthere was also "the Gleason score" but that went in one ear and out the other. He took me off the supplemental testosterone, waited a month, got new readings from Quest and was told I needed to get a biopsy because it looked like I had prostate cancer.

My memory of the next 2 months are kind of hazy. I had ultrasound, then an MRI. He pushed me into the advanced robotic prostate cancer surgery, which I had on June 16th 2022. My entire prostate was removed. I went home the next day and once the catheter was removed a few days later I began to stain my wooden floor blood red. It took about a month before I regained some control over my bladder, and that there was an obvious decrease in the blood mixed with my urine.

A few weeks ago I joined Planet Fitness. I have not actually worked out there yet, because as I stepped out of my bathroom a week after joining I noticed that there was an odd bulge in my lower right abdomen. It looked like the alien in the film Alien. Like something was ready to bust out of my body. Yup, it is a hernia. After spending an hour with Google I found that ever since a European study done in 2013, it has been known that there is a linkage between prostate cancer surgery and hernias. There are standard recommendations of things NOT to do that may keep a hernia from developing after the surgery.

Too late now!

Up until a year ago the only surgery that I ever had was circumcision and tonsils removed. I honestly hate being in the hospital and I'm not too keen on people in the medical field. I've dealt with the past 6 months largely thru denial. I did everything I was told to do but in a robotic fashion.

So to sum up: Last Fall very low PSA. After 5 months of testosterone supplementation to no effect had a series of blood tests. Led to other tests, led to surgery. I never did experience the joy and wonder that I experienced a decade ago when using androgel. And now it seems that sex will be just a distant memory, because I don't intend to create an itch that I then am compelled to scratch.

Why didn't I become Tarzan with the second series of testosterone supplementation? Did I already have prostate cancer, or did the hormone therapy induce the cancer? Can I live with a hernia that mainly shows itself when I'm on the toilet and then gradually recedes, or is that just asking for trouble?

I've posted the same story 2 or 3 times in these forums. You guys must be getting bored! I intend to stay off the forum for awhile until I have something new to contribute. Happy holiday wishes.

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@round5

Because of the side effects would be the simple answer. I know because I’ve been on it intermittently throughout the different treatments I have. Tiredness,weakness,sex drive,ED,bone loss,weight gain. So when a person has a low grade cancer or they catch it early enough it can sometimes be cured or controlled without the hormone therapy.

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The hormone therapy (Lutron) I had Starting at Mayo MN .. the Oncologist said it was to shrink the prostate… and the cancer.. the shot given was 2 months before radiation started.. it was good advice.. to keep living.. I
was 80 years old.. and had had a very good and active life.. I was not willing to second guess Mayo and my local Doctors for the inconvenience of losing sexual drive and performance .

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I was Gleason 8 but the cancer had not metastisized. Initially I was told surgery or Lupron & EBR would be equally successful. However the best surgeon in town suggested against surgery because of my hypertension. So it wasn't really my Gleason scores that forced me to use Lupron.
As for cognitive problems with Lupron I have to admit I seem to be slowing down a little after three doses. Nothing serious but now and then I have trouble finding the right word. (Unfortunately I seem to also have most of the other side effects such as joint pain, muscle loose, weight gain, and growing breasts.)

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