From the Research
Androgen deprivation therapy (ADT) is the primary approach to reduce semen production in prostate cancer patients, and it includes medications like leuprolide (Lupron), goserelin (Zoladex), or degarelix (Firmagon) that suppress testosterone production. These medications are typically administered as injections every 1-3 months. Anti-androgens such as bicalutamide (Casodex), flutamide, or enzalutamide (Xtandi) block testosterone's effects and are usually taken as daily oral tablets. Surgical options include orchiectomy (removal of testicles) which permanently eliminates testosterone production. Radiation therapy to the prostate and seminal vesicles can also reduce semen volume.
Treatment Options
- Medications: leuprolide (Lupron), goserelin (Zoladex), or degarelix (Firmagon)
- Anti-androgens: bicalutamide (Casodex), flutamide, or enzalutamide (Xtandi)
- Surgical options: orchiectomy (removal of testicles)
- Radiation therapy: to the prostate and seminal vesicles
These treatments work by either reducing testosterone levels or directly affecting the prostate and seminal vesicles, which produce most of the seminal fluid. Testosterone drives prostate cancer growth in many cases, so these treatments serve the dual purpose of fighting cancer while reducing semen production. Side effects may include erectile dysfunction, decreased libido, hot flashes, and potential bone density loss with long-term use. The specific treatment choice depends on cancer stage, patient age, and other health factors, as noted in studies such as 1.
Recent Studies
A recent study published in 2022 1 compared the efficacy and safety of different gonadotropin-releasing hormone agonists, including goserelin, triptorelin, buserelin, histrelin, and leuprorelin, and found that they have comparable potential to suppress testosterone levels. Another study published in 2022 2 discussed the evolution of ADT and its new emerging modalities in prostate cancer, highlighting the importance of personalizing treatment options based on patient profile and disease characteristics.
Patient Management
It is essential to educate patients about the potential side effects of ADT and how to manage them, as noted in a study published in 2019 3. Exercise appears to be a helpful strategy in managing many side effects, including weight gain, muscle weakening, fatigue, and reducing medical risks such as cardiovascular disease, type II diabetes, and osteoporosis. Healthcare providers should ensure that patients know about side effects and how to manage them to improve their quality of life.