HRT patches used for menopause could be offered to MEN as prostate cancer treatment, say experts
HRT patches just like those given to menopausal women could be offered to men as a treatment for prostate cancer, a major study suggests.
Researchers found the patches worked just as well as current hormone injections at stopping the disease from progressing, while causing fewer side effects and reducing the need for regular hospital visits.
Prostate cancer is the most common cancer in the UK, with around 63,000 cases and 12,000 deaths each year.
Yet, unlike breast, bowel and lung cancer, there is still no national screening programme.
Scientists from University College London tested whether hormone patches could replace injections in men whose cancer has spread just beyond the prostate – known as locally advanced disease.
These patients are typically given hormone therapy to suppress testosterone, the male sex hormone that prostate cancer relies on to grow.
The study, published in the New England Journal of Medicine, involved 1,360 men with an average age of 72 from cancer centres across the UK.
Some were given standard injections that block testosterone production, while others were treated with patches delivering oestradiol – a form of the female sex hormone oestrogen – through the skin. This suppresses testosterone levels indirectly.
Hormone replacement patches used to treat symptoms of menopause could offer a simpler and less harmful treatment for prostate cancer
The team found the patches were just as effective as injections at controlling the disease.
Standard hormone injections can trigger hot flushes, weakened bones and increased risk factors for heart disease, including raised cholesterol, blood sugar and blood pressure.
By contrast, the patches caused fewer of these problems.
However, they were linked to a higher risk of painful swelling of breast tissue in men – a condition known as gynaecomastia.
Experts said the treatment could also be far more convenient, as injections require regular visits to a GP or hospital, while patches can be applied at home.
The patches used in the trial are the same as those commonly prescribed to women as hormone replacement therapy to relieve menopause symptoms.
Lead author Professor Ruth Langley, from the MRC Clinical Trials Unit at UCL, said: ‘We believe our findings should allow men with locally advanced prostate cancer to choose the hormone therapy that suits them best.
‘For some men, side effects like hot flushes can be very debilitating, so the patches could greatly improve quality of life.’
Caroline Geraghty, senior specialist nurse manager at Cancer Research UK, said the findings showed treatments can be made not only effective, but kinder for patients.
‘This trial shows hormone patches are just as effective as traditional injections at controlling prostate cancer, while being much easier and gentler to administer,’ she said.
‘This could give men greater choice over their treatment, helping them to live not just longer lives, but better lives.’
Simon Grieveson, assistant director of research at Prostate Cancer UK, said hormone therapy side effects can be significant.
‘Results from trials have shown that hormone patches like these are just as effective at delaying cancer progression,’ he said.
‘They also resulted in fewer men experiencing hot flushes, although breast swelling was more common.
‘These patches are more convenient and less invasive, and could give men greater choice based on what matters most to them.’
The findings come as experts continue to debate the future of prostate cancer screening in the UK.
The UK National Screening Committee has previously said a nationwide screening programme using the prostate-specific antigen (PSA) test could do more harm than good.
The test is not always reliable – some men with high PSA levels do not have cancer, while others with the disease can have normal results.
This can lead to unnecessary treatment for slow-growing tumours, with side effects including incontinence and erectile dysfunction.
However, some experts argue wider testing could save lives, particularly among higher-risk groups such as men with a family history of the disease or certain genetic mutations.
A major UK trial, Transform, is now underway to assess whether a combination of tests – including genetic screening and rapid MRI scans – could form the basis of a national programme.
Researchers hope it could pave the way for life-saving changes within just a few years.
