Androgen deprivation therapy (ADT) for prostate cancer
Prostate cancer needs testosterone to grow. Reducing how much testosterone your body makes may slow the cancer’s growth or shrink the cancer temporarily. Testosterone is an androgen (male sex hormone), so this treatment is called androgen deprivation therapy (ADT). It is also known as hormone therapy.
There are different types of ADT that may be used.
Learn more about:
- ADT injections
- Intermittent ADT
- Anti-androgen tablets
- Removing the testicle (orchidectomy)
- Side effects of ADT
The most common form of ADT involves injecting medicine to block the production of testosterone. The injections can be given by your GP or specialist and are usually given every three months. They can help slow the cancer’s growth for years.
ADT injections may also be used before, during and after radiation therapy to increase the chance of getting rid of the cancer. They are sometimes combined with chemotherapy.
Occasionally ADT injections are given in cycles and continue until your PSA level is low. Injections can be restarted if your PSA rises again. This is known as intermittent ADT. In some cases, this can reduce side effects. It is not suitable for everyone.
Often called hormone tablets, anti- androgen tablets are usually used with ADT injections.
Removing the testicle (orchidectomy)
Surgery isn’t a common way to lower testosterone production. If you have advanced prostate cancer, you may choose surgery over regular injections or tablets.
Surgery to remove both testicles is called a bilateral orchidectomy. It is possible to have a silicone prosthesis put into the scrotum to keep its shape. Removing only the inner part of the testicles (subcapsular orchidectomy) does not need a prosthesis.
Side effects of ADT
ADT may cause side effects because of the lower levels of testosterone in the body. Side effects may include:
- tiredness (fatigue)
- reduced sex drive (low libido)
- erection problems
- loss of muscle strength
- hot flushes and sweating
- weight gain, especially around the middle
- breast swelling and tenderness, genital shrinkage
- mood swings, depression, trouble with thinking and memory
- loss of bone density (osteoporosis) – calcium and vitamin D supplements and regular exercise help reduce the risk of osteoporosis
- higher risk of diabetes, high cholesterol and heart disease – your doctor will assess these risks with you.
For ways to manage side effects, talk to your treatment team. To find out more about ADT, visit the Prostate Cancer Foundation of Australia .
Studies show that regular exercise can help manage the side effects of ADT. See Exercise for people living with cancer for examples of different aerobic, strength training and flexibility exercises. It may also be helpful to speak to a dietitian for advice.
Dr Amy Hayden, Radiation Oncologist, Westmead and Blacktown Hospitals, and Chair, Faculty of Radiation Genito-Urinary Group (FROGG), The Royal Australian and New Zealand College of Radiologists, NSW; Prof Shomik Sengupta, Professor of Surgery and Deputy Head, Eastern Health Clinical School, Monash University, and Visiting Urologist and Uro-Oncology Lead, Urology Department, Eastern Health, VIC; A/Prof Arun Azad, Medical Oncologist, Urological and Prostate Cancers, Peter MacCallum Cancer Centre, VIC; Ken Bezant, Consumer; Dr Marcus Dreosti, Radiation Oncologist, GenesisCare, and Clinical Strategy Lead, Oncology Australia, SA; A/Prof Nat Lenzo, Nuclear Physician, Specialist in Internal Medicine, Group Clinical Director, GenesisCare Theranostics and The University of Western Australia, WA; Jessica Medd, Senior Clinical Psychologist, Department of Urology, Concord Repatriation General Hospital, and HeadwayHealth Clinical and Consulting Psychology Services, NSW; Caitriona Nienaber, 13 11 20 Consultant, Cancer Council Western Australia; Graham Rees, Consumer; Kerry Santoro, Prostate Cancer Specialist Nurse, Southern Adelaide Local Health Network, SA; A/Prof David Smith, Senior Research Fellow, Cancer Research Division, Cancer Council NSW; Matthew Starr, Consumer. We also thank the health professionals, consumers and editorial teams who have worked on previous editions of this title. This booklet is funded through the generosity of the people of Australia.
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