The prostate, hormones and fertility

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Many men fear the consequences of treatment for prostate cancer almost more than they fear the cancer itself. These include possible incontinence and impotence, which many see as a threat to their sexuality.

Male sex hormones, such as testosterone, stimulate the growth of prostate cancer. The choice of hormonal therapy as a treatment is called androgen deprivation therapy (ADT). This therapy usually entails the administering of oestrogen or LHRH-androgens.This treatment decreases the levels of male sex hormones in the body. It can also block the hormones from getting into the cancer cells.

Hormone therapy can shrink large tumours and is often used if prostate cancer is in its early stages – sometimes in combination with radiation and surgery. Because it decreases the levels of testosterone in the body, impotence is a possible side effect.

In a study published in the March 20 Journal of the Cancer Institute, 80 percent of the men treated with ADT reported that they had become impotent within a year. Only 30 percent of the men in the group who received no treatment reported impotence. The jury is still out on the long-term benefit of hormonal treatment and as to whether it decreases the cancer risk significantly enough to be used as a routine treatment.

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