Hormone therapy for prostate cancer: should I choose this option?
Dr. Leonard Bokhorst, radiation oncologist
When the best medical option isn’t necessarily the best personal choice
Many men with prostate cancer face a difficult decision:
Should I undergo hormone therapy (ADT) in addition to radiation therapy?
As a radiation oncologist, I see every day just how difficult this decision can be. The guidelines are clear: for certain risk profiles, hormone therapy improves outcomes. The recommendation is therefore often: go ahead with it.
But what is rarely discussed explicitly is that this is also a choice—and that this choice can have a major impact on your daily life.
Why is hormone therapy often recommended?
Hormone therapy (ADT) lowers testosterone levels in the body. Because prostate cancer cells are sensitive to testosterone, ADT can:
make radiation therapy more effective
reduce the risk of disease progression
improve survival rates in some men
Studies have shown this effect particularly in men with multiple risk factors. From a medical perspective, this advice therefore often makes sense.
Why doesn't this feel like a real choice to many men?
In the doctor’s office, many patients take the advice for granted:
“This is the best treatment.”
What is less often mentioned is that the benefits are sometimes relatively limited and that the side effects can be very real and noticeable on a daily basis. As a result, for some people, the decision doesn’t feel like a choice, but rather something they “have to” do.
What are the effects of hormone therapy on daily life?
Lowering testosterone levels affects virtually the entire body. Common side effects include:
Fatigue and low energy levels
Muscle loss and decreased physical strength
Decreased libido and sexual changes
Mood swings or feelings of sadness
For some men, these changes are quite manageable. For others, they have a major impact on their work, relationships, self-image, and quality of life.
When do the disadvantages outweigh the advantages?
That varies from person to person. Some men say:
“If it improves my chances, I’ll take it.”
Others find the side effects more severe than expected—especially when they learn that the expected benefits may be limited to a matter of years or months. This makes it clear that the issue is not only medical, but also personal.
The key question: what’s right for you?
The crucial question is therefore not only:
“Is hormone therapy effective?”
but above all:
“Is hormone therapy the right choice for me?”
That decision depends on:
your risk profile and medical condition
your age and overall physical condition
what matters to you in terms of quality of life
how you view side effects and functionality
Guidelines are valuable, but they should never replace a personal conversation.
Staying in control when facing a complex treatment decision
Choosing the right treatment isn’t just about following a protocol; it’s about understanding, weighing the options, and making a decision. Taking control means:
You know the pros and cons
Your values will be taken into account
you feel free to ask questions and voice your concerns
That takes time, patience, and guidance.
Our guiding principle at Mauro Medical Specialists
At Mauro Medical Specialists, we believe that quality cancer care goes beyond simply “following the guidelines.” We help men with prostate cancer to:
making medical information easy to understand
to gain a clear understanding of the impact on daily life
make choices that truly suit them
Not by passing the buck, but by working together to clarify the situation.
Frequently Asked Questions
Is hormone therapy always necessary with radiation therapy?
No. The recommendation depends on your risk profile and personal situation.
Can I refuse hormone therapy?
Yes. You always have the right to deviate from standard recommendations, provided you are well-informed.
Is it a good idea to seek additional guidance on this matter?
For many men, it is—especially when the medical benefits and personal impact are closely aligned.
Finally
Hormone therapy can be a valuable addition—but only if the treatment fits who you are and how you want to live. The right choice isn’t necessarily the most intensive one, but the one that’s best suited to you.
Schedule an appointment with Mauro
Are you unsure about hormone therapy in combination with radiation therapy and would you like to discuss this in a relaxed and independent setting?
Schedule an appointment with Mauro Medical Specialists.
Together, we’re making room for a choice that’s not only medically sound, but also humane.