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Hormone therapies for prostate cancer aim to reduce androgen levels, which fuel cancer growth. These treatments include:
1. Androgen Deprivation Therapies (ADT):
These therapies reduce the body's overall androgen levels.
* a. Orchiectomy (Surgical Castration):
The testes are the primary source of androgens. This outpatient surgical procedure involves the surgical removal of the testes and is considered the simplest and most cost-effective method of hormone therapy.
* b. LHRH Agonists:
LHRH agonists reduce testosterone production in the testes. This treatment is sometimes referred to as chemical or medical castration because it effectively lowers androgen levels to a similar extent as surgical orchiectomy. LHRH agonists are typically administered as injections monthly or every three months.
* c. LHRH Antagonists:
Examples include Degarelix (Firmagon). These work similarly to LHRH agonists but lower testosterone levels more rapidly and avoid the initial 'flare effect' sometimes seen with agonists. They are used in advanced prostate cancer and administered as monthly subcutaneous injections.
* d. Androgen Synthesis Inhibitors (e.g., CYP17 Inhibitors):
While LHRH agonists and antagonists target androgen production in the testes, prostate cancer cells that have spread throughout the body (metastatic) can still produce small amounts of androgens that stimulate cancer growth. Medications like Abiraterone, a CYP17 inhibitor, block an enzyme called CYP17, thereby inhibiting androgen production not only in the testes but also in the adrenal glands and within metastatic prostate cancer cells. Abiraterone is an oral medication taken daily and is used in the treatment of advanced, hormone-refractory prostate cancer.
2. Androgen Receptor Pathway Inhibitors:
These therapies block the action of androgens at the cellular level.
* a. Anti-androgens:
These drugs prevent androgens from binding to androgen receptors on prostate cancer cells.
* b. Next-generation Androgen Receptor Inhibitors (e.g., Enzalutamide):
When androgens bind to their receptors, these receptors send signals that promote cancer growth and division. Drugs like Enzalutamide block these signals. Enzalutamide is one of the newer generation hormone suppression therapies.
What are the hormone therapies applied in prostate cancer?
1. Androgen Deprivation Therapies (ADT):
These therapies reduce the body's overall androgen levels.
* a. Orchiectomy (Surgical Castration):
The testes are the primary source of androgens. This outpatient surgical procedure involves the surgical removal of the testes and is considered the simplest and most cost-effective method of hormone therapy.
* b. LHRH Agonists:
LHRH agonists reduce testosterone production in the testes. This treatment is sometimes referred to as chemical or medical castration because it effectively lowers androgen levels to a similar extent as surgical orchiectomy. LHRH agonists are typically administered as injections monthly or every three months.
* c. LHRH Antagonists:
Examples include Degarelix (Firmagon). These work similarly to LHRH agonists but lower testosterone levels more rapidly and avoid the initial 'flare effect' sometimes seen with agonists. They are used in advanced prostate cancer and administered as monthly subcutaneous injections.
* d. Androgen Synthesis Inhibitors (e.g., CYP17 Inhibitors):
While LHRH agonists and antagonists target androgen production in the testes, prostate cancer cells that have spread throughout the body (metastatic) can still produce small amounts of androgens that stimulate cancer growth. Medications like Abiraterone, a CYP17 inhibitor, block an enzyme called CYP17, thereby inhibiting androgen production not only in the testes but also in the adrenal glands and within metastatic prostate cancer cells. Abiraterone is an oral medication taken daily and is used in the treatment of advanced, hormone-refractory prostate cancer.
2. Androgen Receptor Pathway Inhibitors:
These therapies block the action of androgens at the cellular level.
* a. Anti-androgens:
These drugs prevent androgens from binding to androgen receptors on prostate cancer cells.
* b. Next-generation Androgen Receptor Inhibitors (e.g., Enzalutamide):
When androgens bind to their receptors, these receptors send signals that promote cancer growth and division. Drugs like Enzalutamide block these signals. Enzalutamide is one of the newer generation hormone suppression therapies.