Prostate Cancer Androgen Hormone Therapy Side Effects
Prostate cancer hormone therapy, or hormonal therapy for prostate cancer, uses various techniques, notably medications and/or surgery, to compromise the ability of the cancer cells to grow. The most common types of prostate cancer – the adenocarcinoma, which account for about 95% of all prostate cancers diagnosed in the United States – are hormone dependent, not as causal factors, but as factors that contribute to the growth and development of the tumor. This was discovered by Nobel laureate Charles Brenton Huggins in the early 1900s, which was what won him the price.
By using surgery, the testicles of a man can be removed – castration – which produce most of the body’s testosterone. Without sufficient testosterone, the prostate gland is unable to produce the needed dihydrotestosterone (DHT) to fuel the growth of all prostate cells, including prostate cancer cells. There are some medications that achieve pretty much the same thing by blocking the body’s ability to produce DHT from testosterone through various techniques.
Some examples are antiandrogens – such as flutamide, bicalutamide, nilutamide, and cyproterone acetate; medications that block the production of dehydroepiandrosterone (DHEA) and other adrenal androgens – such as ketoconazole and aminoglutethimide; and gonadotropine releasing hormone (GnRH) action suppressors – such as GnRH antagonists, e.g. aberelix, or GnRH, e.g. leuprolide, goserelin, triptorelin, and buserelin.
The side effects prostate cancer androgen hormone therapy can be the same for all of these treatment approaches or as varied as they come. It would appear for one as though the most singular successful approaches to hormonal therapy are surgery and GnRH agonists, although total androgen blockage (TAB) may be necessary by combining treatments to achieve the best results.
Surgery (orchiectomy) for one, in addition to the actual problems that come with the loss of testosterone by the body, may have a psychological impact on the patient. That aside, loss of testosterone may cause all of some of hot flashes, weight gain, loss of libido, gynecomastia, impotence, and osteoporosis. GnRH agonists have similar side effects on the long run, but because they often start their action with an increase in the level of the androgens in the body, they may be worse symptoms at the beginning of treatment, such as increased bone pain due to metastasis of the disease.
Antiandrogen medications usually reduce these sad side effects but cause their own set of symptoms as well. Abarelix, a GnRH antagonist, may in fact cause less loss of bone and muscle mass. Medications blocking DHEA action and production, such as Ketoconazole and aminoglutethimide, result in liver damage and skin rashes respectively with prolonged use.
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