Androgen deprivation therapy (ADT)
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. How often you have injections depends on the drug – they may be given monthly, every three months or every six 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 may be given in combination with ADT injections.
Removing the testicle (orchidectomy)
This surgery is not a common way to lower testosterone production. If you have advanced prostate cancer, you may choose surgery over regular ADT 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) also lowers testosterone and 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 that doesn’t go away with rest (fatigue)
- reduced sex drive (low libido)
- erection problems
- shrinking of the testicles and penis
- 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.
Podcast: Making Treatment Decisions
A/Prof Ian Vela, Urologic Oncologist, Princess Alexandra Hospital, Queensland University of Technology, and Urocology, QLD; A/Prof Arun Azad, Medical Oncologist, Urological Cancers, Peter MacCallum Cancer Centre, VIC; A/Prof Nicholas Brook, Consultant Urological Surgeon, Royal Adelaide Hospital and A/Prof Surgery, The University of Adelaide, SA; Peter Greaves, Consumer; Graham Henry, Consumer; Clin Prof Nat Lenzo, Nuclear Physician and Specialist in Internal Medicine, Group Clinical Director, GenesisCare Theranostics, and Notre Dame University Australia, WA; Henry McGregor, Men’s Health Physiotherapist, Adelaide Men’s Health Physio, SA; Jessica Medd, Senior Clinical Psychologist, Department of Urology, Concord Repatriation General Hospital, NSW; Dr Tom Shakespeare, Director, Radiation Oncology, Coffs Harbour, Port Macquarie and Lismore Public Hospitals, NSW; A/Prof David Smith, Senior Research Fellow, Daffodil Centre, Cancer Council NSW; Allison Turner, Prostate Cancer Specialist Nurse (PCFA), Canberra Region Cancer Centre, Canberra Hospital, ACT; Maria Veale, 13 11 20 Consultant, Cancer Council QLD; Michael Walkden, Consumer; Prof Scott Williams, Radiation Oncology Lead, Urology Tumour Stream, Peter MacCallum Cancer Centre, and Professor of Oncology, Sir Peter MacCallum Department of Oncology, The University of Melbourne, VIC.
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