How does Hormone treatment actually work

Email this conversation Print this conversation

User

Posted 29 Nov 2021 at 14:24

I'm Joe - recently finished the Varian Truebeam EBRT 20 fractions 60 gys in total - side effects not too bad.... little bit of additional peeing and some disruption with the bowel but 2 weeks after EBRT things seem to be settling down.

Had Bicalutimide for a month and then Decapeptyl 3mth and now am on the 6 mth injection.

I had the EBRT about 3-4 mths after starting the Bical tabs.

I have been told I may have to stay on the Hormones for 2 -3 years in total.

I understand the Hormone Decapeptyl disrupts the pituitary gland which in turn can stop the adrenal glands producing as much testosterone, so can help to control prostate cancer. Prostate cancer depends on testosterone to grow. So triptorelin/decapeptyl can shrink the cancer or slow its growth by limiting .

External beam radiation for prostate cancer kills cancer cells by destroying the genetic material that controls how cells grow and divide. Hopefully it gets them all?

I'm not understanding why I remain on Decapeptyl after EBRT - does the hormone treatment also limit cancer cell reproduction? And because of this they can die? Can someone enlighten me on the technicalities of after EBRT hormone treatment?

Cheers

Joe

User

Posted 29 Nov 2021 at 16:17

After RT, my oncologist says I will be on hormone treatment for the rest of my life; but that it used to be the case that they were discontinued after a given period. My testosterone became undetectable after 3 months of zolodox. PSA now undetectable (<0.03) following RT.

Edited by member 29 Nov 2021 at 16:20 | Reason: Not specified

User

Posted 30 Nov 2021 at 00:34

Don't think adrenal glands are involved https://www.google.com/amp/s/www.endocrineweb.com/amp/1114

But if you substitutes testes for adrenal gland your understanding is correct.

I don't know exactly what the function of HT is after EBRT. One thing you should know is that cancer cells damaged by EBRT do not die straight away they die next time they divide which may be up to 18 months after EBRT. So continuing HT after EBRT does mean that the cancer cells are suffering the problems of DNA damage and lack of testosterone at the time of division. Presumably this double whammy helps ensure their division is a failure.

Dave

User

Posted 30 Nov 2021 at 01:28

Originally Posted by: Online Community Member

I have been told I may have to stay on the Hormones for 2 -3 years in total.

External beam radiation for prostate cancer kills cancer cells by destroying the genetic material that controls how cells grow and divide. Hopefully it gets them all?

Cheers

Joe

The cans in your research are misleading - in almost all cases, the decapeptyl (like other similar hormones) switches off your testosterone production completely which starves the cancer. The EBRT does destroy the genetic material of a cancer cell but it takes about 18 months to do its worst because prostate cancer cells divide and multiply very slowly. So in the 18 months after your EBRT, the cancer could continue to spread if it wasn't being starved.

There is plenty of research now to indicate that being on HT for 3 years post RT provides no additional benefit over just being on it for 18 months - you might want to discuss that with the onco as you get nearer to the 18 month mark as it will depend somewhat on how your PSA is behaving.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User

Posted 30 Nov 2021 at 02:01

Almost completely correct about slow death (apoptosis) of cancer cells as they divide over time but RT does also kill some cancer cells in the process of dividing as the RT is given. This is mentioned along with a lot of other interesting things https://www.cancer.org/content/dam/CRC/PDF/Public/6151.00.pdf

As regards having HT for an extended period after RT, this can kill or constrain some radio resistant or escaped cancer cells and provide an unfriendly environment for stray cancer cells. However, over time, unaffected cancer cells can learn to survive over anything from months to years as they become unaffected by being deprived of Testosterone. There are web pages that go into this in much greater detail.

Edited by member 30 Nov 2021 at 02:02 | Reason: Not specified

Barry

User

Posted 30 Nov 2021 at 08:46

RT damages the DNA of all the cells in the target area, cancer cells and normal cells alike. Normal cells can repair their damaged DNA, but the repair mechanism in cancer cells is usually faulty, so eventually the cells dies. This can take many months, though, and the HT stops the cancer cells from dividing while they die.

Best wishes,

Chris

Email this conversation Print this conversation

Join the online community now.

Click through to become a member and gain access to support, information and real time replies.