MANAGEMENT OF HORMONAL TREATMENT EFFECTS

Androgen ablation is an effective palliative treatment of advanced car cinoma of the prostate. A variety of drugs with diverse mechanisms of action, effectiveness, and side effects are used to treat patients wit h this disease. This paper discusses the management of the most common side effects that result from treatment with luteinizing hormone-rele asing hormone (LHRH) agonists, antiandrogens, ketoconazole, estrogens, and progestational agents. The most common side effects are loss of l ibido and impotence, hot flushes, gynecomastia, the ''flare'' phenomen on (LHRH agonists), nausea and vomiting, liver toxicity, and thromboem bolic events (estrogens). The flare phenomenon associated with LHRH an alog treatment is prevented best by pretreatment with antiandrogens or estrogens. Progestational agents can reduce hot flashes markedly. Gyn ecomastia may be prevented by preliminary breast irradiation. Erectile dysfunction is the most problematic side effect and possible treatmen ts for this condition are discussed.