Prostate Cancer (cont.)
What about hormonal treatment for prostate cancer?
The male (androgenic) hormone is called testosterone. It
stimulates the growth of cancerous prostatic cells and, therefore, is the
primary fuel for the growth of prostate cancer. The idea of all of the hormonal
treatments (medical and surgical), in short, is to decrease the stimulation by
testosterone of the cancerous prostatic cells. Testosterone normally is
produced by the testes in response to stimulation from a hormonal signal called
LH-RH. The LH-RH stands for luteinizing hormone-releasing hormone and is also
called gonadotropin-releasing hormone. This hormone comes from a control
station in the brain and travels in the blood stream to the testes. Once there,
the LH-RH stimulates the testes to produce and release testosterone.
Hormonal treatment, also referred to as androgenic
deprivation (depriving the prostate of testosterone), can be accomplished
surgically or medically. The surgical hormonal treatment is removal of the
testes in an operation called an orchiectomy or a castration. This surgery thus
removes the body's source of testosterone. The medical hormonal treatment
involves taking one or two types of medication. One type is referred to as the
LH-RH agonists. They work by competing with the body's own LH-RH. These drugs
thereby inhibit (block) the release of LH-RH from the brain. The other type of
drug is referred to as anti-androgenic, meaning that these drugs work against
the male hormone. That is, they work by blocking the effect of testosterone
itself on the prostate.
Today, most men electing hormonal treatment choose
medication over surgery, probably because they view surgical castration as more
devastating cosmetically or psychologically. Actually, however, the
effectiveness and side effects of medical hormonal treatment as compared to
surgical hormonal treatment are very much the same. Both types of hormonal
treatment usually effectively eliminate stimulation of the cancer cells by
testosterone. Some tumors of the prostate, however, do not respond to this form
of treatment. They are referred to as androgen-independent prostate cancers.
The principal side effects of all of these hormonal treatments (that is, the
side effects of androgenic deprivation) are enlarged breasts (gynecomastia)
that often are tender, flushing (like hot flashes), and impotence.
The LH-RH agonists, leuprolide (Lupron) or goserelin
(Zoladex), are given as monthly injections in the doctor's office. The
anti-androgenic drugs, flutamide (Eulexin) or bicalutamide (Casodex), are oral
capsules that are used usually in combination with the LH-RH agonists. The
LH-RH agonists are often effective alone. The anti-androgenic drugs are added,
however, if the cancer progresses despite the use of the LH-RH agonists. The
hormonal treatments may have value, as well, when combined with radiation
therapy. Studies are currently being conducted to determine if hormonal therapy
enhances the therapeutic effect of radiation.
Generally, hormonal treatment is reserved for individuals
who have advanced prostate cancer with local spread or metastases.
Occasionally, an individual with organ-confined (localized) prostate cancer
will receive hormonal treatment because he has severe associated medical
problems or simply because he refuses to undergo surgery or radiation. Hormonal
treatment is used in less than 10% of men with organ-confined
(localized) prostate cancer. Remember that the intent of hormonal therapy
usually is palliative. This means that the goal is to control the cancer rather
than cure it because a cure is not possible.
Next: What is cryotherapy for prostate cancer? »
- goserelin-injection, Zoladex - Consumer information about the medication GOSERELIN - INJECTION (Zoladex), includes side effects, drug interactions, recommended dosages, and storage information. Read more about the prescription drug GOSERELIN - INJECTION.
- CT Scan (Computerized Axial Tomography) - CT Scan (Computerized Axial Tomography, CAT scan) is a procedure that assists in diagnosing tumors, fractures, bony structures, and infections in the organs and tissues of the body.
- Prostatitis - Read about prostatitis, a painful infection of the prostate gland. Symptoms include fever, chills, painful urination, lower back pain, pain in the genital area, and frequent urination.
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