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- Hot flashes with severe
sweating
- Osteoporosis (loss of bone
mass that makes bones break easily)
- Decreased libido (desire
for sex)
- Erectile dysfunction
(problems with having or maintaining an erection)
- Fatigue
- Depression or
irritability
These symptoms may also occur in men without prostate
cancer, as part of the aging process. In men without prostate cancer,
treatments to raise testosterone levels can help relieve these symptoms.
Because testosterone helps prostate cancer grow, these treatments are not
an option for men with prostate cancer.
Osteoporosis treatment
Men who have received androgen ablation therapy (treatment that stops the
production of testosterone) are at higher risk for developing
osteoporosis. Androgen ablation therapies include medications that stop
the body from producing testosterone or orchiectomy
(surgery to remove the testicles).
Most research into how to prevent and treat osteoporosis has been
conducted with women because osteoporosis is much more common in women
than men. Doctors are exploring if osteoporosis treatments should be different
for men because men's hormone levels are different. Some treatments that
may help prevent or slow osteoporosis in men are described below.
Treatments may be given alone or in combination.
Calcium and vitamin D. Supplements of calcium and vitamin D have
been shown to reduce bone loss in men and women over 65. The recommended
levels are 1,000 to 1,500 milligrams (mg) of elemental calcium and 400 to
600 international units (IU) of vitamin D daily. Talk with your doctor
before taking supplements.
Bisphosphonates. The following
drugs may reduce bone loss in men:
- Alendronate (Fosamax),
which is given orally and used to treat osteoporosis in women and
men
- Pamidronate (Aredia),
which is given intravenously (IV), and recently has been shown to
reduce bone loss in people with cancer
- Zoledronate (Zometa),
which is given intravenously (IV), and recently has been shown to
reduce bone loss in people with cancer
- Risedronate (Actonel),
which is given orally, and recently has been approved for treating
women with osteoporosis
Estrogen. Estrogen may be even more important
in preserving bone mass than testosterone. Men's bodies normally have low
levels of estrogen, so maintaining these levels may help prevent
osteoporosis. However, this treatment requires further study before it is
proven to be effective.
Reducing the risk of osteoporosis
The following actions may help reduce the risk of developing
osteoporosis:
- Perform weight-bearing
exercise, such as walking 20 to 30 minutes per day.
- Maintain an ideal body
weight.
- Take vitamin D
supplements.
- Take calcium
supplements.
In addition, your doctor may recommend a bone density test
or offer medications, such as the bisphosphonates
mentioned above.
Treatment of hot flashes
Up to 75% of men receiving hormone treatments for prostate cancer have
hot flashes. The following treatments may help:
- Antidepressants, such as
venlafaxine (Effexor)
and sertraline (Zoloft), have been shown
to reduce hot flashes and help with the mood problems or
irritability often associated with changes in hormone levels.
- A nonhormonal
medication, gabapentin (Neurontin), may be helpful in treating hot
flashes in men.
- Vitamin E supplements
(up to 800 IU/day) have been shown to relieve hot flashes for women,
but it is uncertain how effective vitamin E supplements are for men
experiencing hot flashes.
- Exercise
- Deep breathing and other
relaxation techniques
- A cooler room
temperature
- Progesterone agents,
such as megestrol acetate (Megace), are very effective in reducing hot
flashes in women. There is concern that the use of these agents in
men may be connected to a rising prostate-specific antigen (PSA)
level, which may indicate prostate cancer, so this drug may not be a
safe treatment for men. Nonetheless, if monitored by a doctor,
progesterone agents may be reasonable to try.
- Clonidine (Catapres),
a blood pressure medication, has not shown to be very useful for
treating hot flashes in men, even though it has shown to reduce hot
flashes for women.
More Information
Managing Side Effects: Sexual Dysfunction
PLWC: Managing Side Effects
Cancersymptoms.org: Hormonal Disturbances
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