It’s because of this variability in cases, goals, and treatment paths that you’ll be empowered to help guide your own treatment.
Here are some factors to consider when you and your healthcare providers are deciding on hormone therapy for metastatic prostate cancer:
Side Effects of Hormone Therapy
- Diarrhea
- Erectile dysfunction
- Fatigue
- Gynecomastia (breast tissue growth)
- Hot flashes
- Insulin resistance
- Nausea and vomiting
- Low libido
- Osteopenia and osteoporosis (weakened bones)
- Sarcopenia (loss of muscle mass)
Armstrong points out that androgen synthesis inhibitors are taken with corticosteroids, which come with their own side effects, such as mood swings, weight gain, headaches, and osteoporosis.
Treatment Goals
Your own goals — and what you want from treatment — will inform just about all of your treatment decisions. “It’s not so much that some treatments are good and some are bad, it’s more like each has advantages and disadvantages,” says Dawson.
“Some patients will say, ‘I want the best quality of life, the treatment that interferes with my life the least.’ Others say, ‘Anything to extend life.'” says Dawson. “Some people will want pills; some say they take enough pills already and want injections. Some are willing to do chemo with hormone therapy, while others think it will interfere too much with quality of life.”
And the burning question: “Patients want to know how long they’ll live,” says Dawson. “I expect they’d respond to treatment for years. I don’t like to get pinned down with an average because people hone in on that and it’s not in their best interest. In a person with aggressive disease, they may stop responding within six months. In others, it could be 10 to 15 years.”
As variable as cases and treatments are, many people with metastatic prostate cancer are living with it for a long time, so treatments are tailored to their goals and lifestyle. “People [taking hormone therapy] usually feel pretty good, so they’re traveling and spending time with their families,” says Dawson. “People on hormone therapy are out there living their lives. You wouldn’t know who’s on hormone therapy.”