LHRH antagonists can be used to treat advanced prostate cancer. A flare can be avoided by giving drugs called anti-androgens (discussed below) for a few weeks when starting treatment with LHRH agonists. If the cancer has spread to the spine, even a short-term increase in tumor growth as a result of the flare could press on the spinal cord and cause pain or paralysis. Men whose prostate gland has not been removed may have trouble urinating. Men whose cancer has spread to the bones may have bone pain. This effect, called tumor flare, results from the complex way in which these drugs work. When LHRH agonists are first given, testosterone levels go up briefly before falling to very low levels. The LHRH agonists available in the United States include: Depending on the drug used, they are given anywhere from once a month up to once every 6 months. LHRH agonists are injected or placed as small implants under the skin. With these drugs, the testicles stay in place, but they will shrink over time, and they may even become too small to feel. Treatment with these drugs is sometimes called medical castration because they lower androgen levels just as well as orchiectomy. Luteinizing hormone-releasing hormone (LHRH) agonists (also called LHRH analogs or GnRH agonists) are drugs that lower the amount of testosterone made by the testicles. If wanted, artificial testicles that look much like normal ones can be inserted into the scrotum. Some men having this surgery are concerned about how it will look afterward. Because of this, they may choose treatment with drugs that lower hormone levels (such as an LHRH agonist or antagonist) instead. But unlike some of the other treatments, it is permanent, and many men have trouble accepting the removal of their testicles. It is probably the least expensive and simplest form of hormone therapy. This causes most prostate cancers to stop growing or shrink for a time. In this operation, the surgeon removes the testicles, where most of the androgens (such as testosterone and DHT) are made. Orchiectomy (surgical castration)Įven though this is a type of surgery, its main effect is as a form of hormone therapy. Treatment to lower testicular androgen levelsĪndrogen deprivation therapy, also called ADT, uses surgery or medicines to lower the levels of androgens made by the testicles. Several types of hormone therapy can be used to treat prostate cancer. Before radiation to try to shrink the cancer to make treatment more effective.Along with radiation therapy as the initial treatment, if you are at higher risk of the cancer coming back after treatment (based on a high Gleason score, high PSA level, and/or growth of the cancer outside the prostate).If the cancer remains or comes back after treatment with surgery or radiation therapy.If the cancer has spread too far to be cured by surgery or radiation, or if you can’t have these treatments for some other reason.But hormone therapy alone does not cure prostate cancer. Lowering androgen levels or stopping them from getting into prostate cancer cells often makes prostate cancers shrink or grow more slowly for a time. Most androgens are made by the testicles, but the adrenal glands (glands that sit above your kidneys) as well as the prostate cancer cells themselves, can also make androgens. The main androgens in the body are testosterone and dihydrotestosterone (DHT). The goal of this treatment is to reduce levels of male hormones, called androgens, in the body, or to stop them from fueling prostate cancer cell growth.Īndrogens stimulate prostate cancer cells to grow. Hormone therapy is also called androgen suppression therapy.
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