Hormone therapy

Nope, it can be a monotherapy.

But if you have radiation, HT is frequently used.

What are the side effects that you have experienced with hormone therapy? I have read the lists, how about intensity? Broken bones, exposed jaw bone????

ADT often precedes radiation therapy as in helps radio-sensitize the PCa so the radiotherapy is more effective. It is normal to include ADT in high risk and advanced PCa cases.

I was on ADT for just over three years due to my high risk situation. The main side effect of ADT drugs like Lupron/Eligard/Firmagon is to stop the production of testosterone. There are several side effects of reduced T levels whether it is due to ADT or physical orchietomy. The most common include hot flashes, fatigue, weight gain, loss of libido. Most men have these in some way. Also potential include bone density loss, depression, slower mental performance and general malaise. Bone breaks are very rare. When you are on long term ADT (more than 6 months) most all docs will frequently monitor bone density and if needed use drugs designed to combat it. These drugs can cause jaw bone necrosis and must be carefully used.

For me, the worst were the hot flashes and weight gain. I kept up my energy and libido primarily through diet and exercise improvements. These also helped with the hot flashes. I was never depressed and I don't believe it affected my mental performance. Thankfully once the remaining drugs metabolized and my T levels increased the side effects subsided and disappeared....except for about half of the weight gain.

As always, each of us is different and the side effects will rarely be the same in any two men. When they got bothersome I always reminded myself that the side effects of ADT were for preferable to the side effects of the prostate cancer.

There are some ways to help with "hormone therapy", ADT, or as Fairwind bluntly says, chemical castration.

I took Megace to reduce hot flashes, and it did cut them about 75% or so. Nothing else was ever offered.

There are recommendations for low dose estradiol patches to help with hot flashes and bone density loss. The hot flashes are annoying, but the bone problems are more concerning. I'm not sure how well estradiol helps with the worst side effect for me, the relentless fatigue. The doses are well below what people take for transgender stuff, so there's little risk of "feminizing" effects, even though it is of course a "female" hormone.

This 2018 study was very brief, just a month. But it does look specifically at the short term effects of an estrogen cream application. There isn't a lot of information about this approach that I can find, for what it's worth. Dr. Snuffy Myers promoted this idea.

Transdermal estradiol reduced hot flashes and bone resorption in men with prostate cancer

Is hormone therapy a form of Chemo? Is it considered Chemo?

It seems to be by definition at Cancer.org.
Chemotherapy is the use of any drug to treat any disease. But to most people, the word chemotherapy means drugs used for cancer treatment. It's often shortened to “chemo.” Surgery and radiation therapy remove, kill, or damage cancer cells in a certain area, but chemo can work throughout the whole body.


Also, it is listed at Chemocare.com.

Yep. Technically it’s Chemotherapy. In practice it usually isn’t referenced as such. Chemo is usually reserved to describe the traditional cancer drug therapies that most everyone is familiar with. Helps to simplify things.

Simply external beam radiotherapy that uses proton radiation instead of the traditional more common photon radiation. It can focus a thinner beam of radiation than photon based. It’s advantages are greatest in uses like head and neck cancers and pediatric cancers whic present smaller targets.

For prostate cancer It has proven to be no better than the photon based external radiotherapy like IMRT, IGRT, SBRT. However it is far more expensive on the order of 2-3 times the cost. Over the past several years Medicare and most health insurance will not approve it unless the provider offers a drastic price reduction comparable to photon treatment.

One of the newest centers opened recently here in Atlanta. It opened three months ago several years late at huge cost overruns. Total cost as I remember was well over $300 million. Emory manages the center and PCa is listed as a type cancer treated.

In 2017 Mayo opened their Proton Center and deeply reduced rates on Proton for PCa to qualify for Medicare and Insurance reimbursements. At the time they said it would be temporary. Most Proton Centers haven’t deep discounted their rates for PCa and I have read where utilization has dropped significantly. I recently read a report from UC Berkeley that reported Proton cost average of $69,000 versus IMRT average at $29,000 in 2016.

Last May ASTRO set guidelines that Proton therapy for PCa should only be performed in trials as it had not shown advantages over IMRT/IGRT yet was more costly. They state that Proton Therapy is not medically necessary for PCa treatment. This guideline influences third party payors when they approve of procedures for reimbursement.

Clearly Proton therapy has been well proven to be more effective in several cancers, but not with PCa.

JNF n Mumbo yeppers you guys pretty much summed it up. The only PCA guys I know from the hope lodge that were getting proton were for the guys that had metastasized where they were going after an individual tumor. There were quite a few women that were being treated for Breast Cancer that were getting the proton beam. As Mumbo said it is quite unique I toured it a couple of times when I was down there. It sure is busy, treatments start at 6:30 for the children and I would walk over with people as late as 10:00 at night. They have the kids come early cause they have found out that children are more relaxed and less stressed out in the mornings.

Larry