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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@tlems

I am agreeing with hbp on spino's recent post. This is one of those decisions in life that you can use all the intelegent assistance you can get. Hang in there and best wishes on your next scan and blood work hbp.

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I had RP, then 44 photon radiation treatments, and two years of Lupron injections. So far, they are working. I have stage 4 aggressive cancer. After my surgery, they found cancer cells in my lymph nodes. The treatments wore me out. I am fatigued all the time and lost most of my muscles. My private parts all shrunk after each of the treatments. They currently do not work for sexual functioning. The good news is I am still alive.

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@hbp

Excellent post Spino. I have Gleason 9, stage 3C , seminal invasion PC and I had 6 months of ADT before RP, in a clinical trial at UCLA. My surgeon and medical team, advised me that the ADT before surgery was not presently the standard of care, but it would make the cancer softer and facilitate cutting out all of the cancer and perhaps get a cure of my aggressive, CR , advanced, PC. (a cure is defined as cancer free for 5 years). Getting ADT before RP was possible for me due to the clinical trial. I was also on ADT and Erleada for 6 months post RP. There are many ways to skin a cat with this damn PC but I think that the most important thing is having excellent and caring and very experienced medical practitioners, at an excellent, modern facility, and being a good listener and doing your homework. I think that no matter how much homework you do, and how smart you are, your knowledge is still that of a layman and not equal or superior to your excellent medical team. I have a pet scan and blood test scheduled in the next 2 weeks and hopeful for a good report

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Excellent posts by @spino and @hbp. I agree with what they are both saying. At age 74, I was on active surveillance for 2 years, had RP, 2years later had recurrence and elected to have salvage radiation with 6 months of hormone therapy (Zoladex). My two PSA's, post radiation, are undetectable, although it will probably be another 6 months before we know whether it was SRT or the ADT that brought my PSA down to zero. We are all on a long journey with many twists and turns along the way.

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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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My worse side effects are mostly hot flashes, which my urologist said would probably happen. There may be other side effects but, at 82, I can just blame age.

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