By Pat Carragher - September 13, 2021
Androgen deprivation therapy, or ADT, can be an effective form of prostate cancer treatment, but it also comes with a daunting set of side effects.
Patients undergoing ADT may experience a combination of the following:
- Loss of interest in sex
- Erectile dysfunction
- Hot flashes
- Loss of bone density
- Loss in muscle mass and strength
- Weight gain
- Mood swings
- Insulin resistance
These side effects happen because androgens are male sex hormones, most notably testosterone and dihydrotestosterone (DHT). While they’re required for normal function of the prostate, these hormones also provide fuel to help prostate cancers develop and grow. When the hormones are reduced during treatment, it creates physical and psychological changes.
A new virtual education program is available to help ADT patients face these changes. This program is a first of its kind for Moffitt Cancer Center, as it’s geared not just for patients, but for their partners, as well. The class starts Sept. 18 and is co-led by Moffitt’s Supportive Care Medicine, Behavioral Medicine, Social Work and Genitourinary Oncology departments.
Marc McDowell, a licensed clinical social worker at Moffitt, says sexual side effects are often a taboo subject for patients.
“Men are going through a lot of those symptoms they’ve never experienced before,” said McDowell. “Testosterone removal just affects the body in so many different ways and men usually aren’t prepared for it.”
During the first hour of the virtual education class, patients and their partners will learn about some of the more bothersome side effects from ADT, as well as those that aren’t always noticed by patients. The group’s facilitators will share evidence-based strategies for managing the side effects. The last half hour of the class is dedicated to discussing well-established, motivational exercises to encourage attendees to develop a healthy lifestyle.
“You really can’t get away from the erectile dysfunction,” said Dr. Kristine Donovan, a psychologist in Moffitt’s Behavioral Medicine Program. “It’s very unlikely your husband is going to be able to get an erection sufficient for intercourse, but let’s not punish him for that. Let’s talk about it, let’s work around it and talk about the ways to maintain intimacy and keep you united as a couple.”
Men with early stage prostate cancer with an intermediate or high risk of recurrence can receive hormone therapy before, during and/or after radiation therapy or surgery to remove the prostate gland. This kind of therapy may be recommended for men with recurrent prostate cancer after previous treatment with radiation or surgery. It can also be recommended for men who have advanced or metastatic prostate cancer.
Dr. Monica Chatwal, an oncologist in Moffitt’s Genitourinary Oncology Department, believes that while the side effects of ADT can be intimidating, patients should still be open to hormone therapy because of its success in keeping prostate cancer at bay.
“It’s very effective,” said Chatwal. “In the recurrent setting, sometimes ADT alone, even for a short period of time, can get their cancer under control. When prostate cancer metastasizes, it can be very responsive to hormone therapy. Over time, ADT may stop working by itself and they may need other treatments, but it can still be very effective and the survival is typically years.”
Chatwal also wants patients and their partners to know that ADT is not an “all or nothing” approach.
“It’s important to remember that we’re always here to make sure they’re on the appropriate treatments,” said Chatwal. “If it’s causing a problem, then we can modify it. We can work together with the patient to help tailor the treatments as best as possible.”
New Virtual Education Program
WHO: Prostate cancer patients on ADT and their partners
WHAT: Androgen Deprivation Therapy Virtual Education Program
WHEN: Every third Wednesday of the month
WHERE: Zoom link provided upon registration
REGISTER: Contact Rosemary Santana at 813-745-1246 or Rosemary.Santana@Moffitt.org