What Happens When Hormone Therapy for Prostate Cancer Stops Being Effective at Age 70?

As men age, their bodies undergo various changes. One of these is the progression of prostate cancer, particularly when hormone therapy, also known as Androgen Deprivation Therapy (ADT), becomes ineffective. When hormone treatment stops working, prostate cancer often becomes resistant to hormonal therapy, developing into a much more challenging form known as castration-resistant prostate cancer (CRPC). This article explores the implications and considerations for men approaching 70 years old facing this scenario.

Understanding Prostate Cancer and Hormone Therapy

Hormone therapy, or ADT, is a common approach to treating prostate cancer. It works by reducing the levels of male hormones, called androgens, in the body or preventing them from reaching prostate cancer cells. This method aims to shrink tumors or slow their growth. However, for many men, prostate cancer eventually becomes resistant to hormone treatment. When this happens, patients may find themselves in a crisis situation known as CRPC.

The Development of Castration-Resistant Prostate Cancer

When prostate cancer becomes castration-resistant, it means the cancer has managed to grow and spread even with extremely low levels of androgens. At this stage, several key events typically occur:

The prostate-specific antigen (PSA) levels in the blood begin to rise consistently. This signifies that the cancer is progressing. New tumors may emerge or existing ones may grow more aggressively. These new growths can be detected using imaging tests such as CT scans, MRI, or bone scans. The cancer tends to become resistant to additional hormone therapies. Switching to another form of ADT usually does not effectively control the cancer for long. Cancer cells can start to cause new or worsening symptoms, such as bone pain, fatigue, weight loss, and urinary problems. Without additional treatment, the cancer will likely continue to worsen over a period of 12 to 30 months.

The transition from effective hormone therapy to CRPC marks a significant shift in the course of the disease. At this stage, additional treatments become necessary, often including chemotherapy drugs or advanced targeted therapies.

Managing CRPC Effectively

For patients entering their 70s, the development of castration-resistant prostate cancer is a critical milestone. It signifies that the cancer has found a way to bypass the effects of hormone treatment. Once this resistance develops, the cancer typically resumes its aggressive progression and begins to cause worsening symptoms.

By understanding the implications of this development, patients can be better prepared for the additional treatments required. Regular monitoring through blood tests and imaging is crucial to detect hormone resistance at the earliest possible stage, allowing for timely intervention and management. Discussing alternative treatments with your oncologist is also essential to explore the best options available.

Conclusion

The progression of prostate cancer to castration-resistant form is a significant challenge for patients who have been undergoing hormone therapy. It highlights the cancer's ability to resist the effects of treatments designed to reduce hormone levels. Once this resistance develops, the disease usually progresses and causes worsening symptoms.

By comprehending what happens when hormone treatment ceases to be effective, patients can be better equipped to manage their condition. Staying vigilant with monitoring tests is key to detecting hormone resistance early on, allowing for more effective management and potential reversal of the cancer's progression.