As a prostate
cancer hormone therapy, estrogen is no longer used
as much because of the risk of cardiovascular side effects.
Many researchers believe that medical and surgical castration
is safer and more effective than the use of estrogen, although
estrogen will not cause hormone
flare like the LHRH
agonist. Estrogen is the primary sex hormone for females
and the synthetic form of the drug, usually diethylstilbestrol,
can be used to treat disease in both men and women.
Diethylstilbestrol acts similarly to estrogen, but in a man’s body, the brain will read estrogen simply as ‘sex hormone.’ Once the synthetic hormone has entered a man’s bloodstream, the hypothalamus mistakes estrogen for testosterone. Because the level of sex hormone appears to be normal, the hypothalamus stops making luteinizing hormone-releasing hormone (LHRH). Though it is a sex hormone, estrogen cannot fuel prostate cancer cells. The lack of LHRH causes the levels of testosterone to drop to zero.
Estrogen causes increased blood
clotting. Patients who opt for estrogen as their prostate
cancer hormone therapy run the risk of blood clots in
the legs, heart attacks, strokes, and other vascular
accidents. Estrogen, however, is sometimes used to augment
prostate cancer hormone therapy. The side effects of
hormone therapy include cognitive disturbances which
can result in poor memory, slower memory, depression,
or confusion. Estrogen as a patch that releases low
level hormones over a period of time may dramatically
mitigate these side effects.
Diethylstilbestrol, the most common
synthetic form of estrogen therapy, is available in
the United States and is taken as a tablet once a day.
Men who opt for estrogen therapy, either as monotherapy
or as an augmentation to their prostate cancer, should
try to take the dose around the same time every day.
Taking a hormone drug around the same time every day
ensures a steady stream of therapy for the patient.
If a patient forgets a dose until close to the next
day’s designated medicine time, he should then
forgo the dose from the day before and take the drug
only for that day. Patients should not take double doses
or extra doses.
Patients who want to consider hormone
therapy as their prostate
cancer treatment should alert their doctor about
other medical problems, such as: blood vessel disease,
blood clotting disorders, high blood pressure, diabetes,
high levels of calcium in the blood, and liver disease.
Before starting hormone therapy, patients should always
alert their doctors to whether or not they are taking
any other type of medication that may interact with
the prostate cancer treatment.