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For males suffering from prostate cancer,
they are at risk for developing gynecomastia as a result of needed hormone
replacement therapies. That is why prophylactic breast radiotherapy is
performed after every session.
Gynecomastia is a term for the development
of female breasts in a man’s chest due to the proliferation of breast tissue.
It is also known in street slang as “man boobs” or “bitch tits”, and it is
caused by an imbalance in hormones with the scale tipping towards the female
hormones.
Yes, men do have some estrogen, and when
the amount of androgens are overridden by the female hormones is when secondary
sex characteristics appear; increased breast size being one of them.
However there are also other causes that
trigger gynecomastia in males. It could be due to diet, anabolic steroids,
chronic liver disease, marijuana use, and hormone treatment for men with
prostate cancer.
The usual treatment given to those with
advanced prostate cancer are antiandrogen drugs. This is in response to the
increased levels of androgen as a result of this type of cancer. That is why
anti-androgen drugs are necessary. And this hormone treatment is known as
androgen deprivation therapy or androgen ablation.
Studies found that hormone therapy done as
adjunct treatment to radiation therapy as treatment for the kind of prostate
cancer that is more likely to come back is effective in prolonging a patient’s
chance to live. But these patients should be prepared for the side effects that
the treatment can produce, with gynecomastia being one of the prominent
outcomes.
That is why low-dose radioatherapy is done
as prophylactic or preventive treatment for cancer patients receiving hormone
therapies. Studies provide support to its success, one being the Scandinavian
study which aimed to prove the significance of breast prophylactic radiotherapy
in reducing the incidence of gynecomastia in men who received anti-androgen
treatment.
In the mentioned study, it was discovered
that 71% of patients who did not receive any prophylactic treatment developed
gynecomastia. Meanwhile only 21% among those who had low dose radiotherapy grew
man boobs.
In a study that was conducted by Ozen et.al., which sought to find the necessity of prophylactic breast radiotherapy for
all patients with prostate cancer and gynecomastia, they found that there is some amount of improvement for those who received therapy.
In a span of 12 months, there research
found out that there was an much lesser occurrence of gynecomastia for those
who had radiotherapy, with 15.8% compared to 50.8% from the non-prophylactic
group. The study also showed that there was lesser reports of pain and
discomfort among from the prophylactic group.
However, according to this study the
numbers were not significant enough to warrant a necessity of prophylactic
breast radiotherapy for prostate cancer patients under hormone treatment. The
researchers concluded that not all patients need prophylactic treatment because
according to their results, only 54% were significantly bothered by the
formation of man boobs.
The researchers suggested that individual evaluation
should be done to assess which patients really need prophylactic breast radiotherapy
for gynecomastia. A similar study
conducted by Lewis, Cassoni and Payne also had the same conclusion. This treatment
is done for younger patients who have a longer lifespan wherein a recurrence of
the cancer is highly likely.
