Application of Testosterone Therapy After Prostate Surgery

July 22, 2009 by  
Filed under Prostate Cancer

Once prostate cancer is diagnosed early, a decision has to be made whether to treat it immediately or to wait and watch for a while to see if it progresses. The disease should be slow growing, and in several cases, the patient may age and die of other causes before the cancer produces any outward symptoms; but in some instances the cancer just keeps on growing.

One a progression is observed treatment is administered because the cancer is viewed as an aggressive manifestation of the disease. In such an early stage, prostatectomy is often preferred, which is meant to remove the prostate gland, and with it the cancer that is growing within. The problem? The PSA levels in the patient should drop shortly afterward to 0, but sometimes it doesn’t. When that happens, they could be looking at an even more aggressive form of the cancer than was diagnosed, or worse, the cancer could have progressed further than was perceived when the condition was staged.

Hormonal therapy is usually a common consideration in such an instance. Because of the overwhelming evidence that prostate cancer depends in a large way on the hormones that are produced by the male reproductive system, the removal of the testicles to inhibit the production of testosterone is an efficient hormonal therapy that should slow the progression of the disease if nothing else.

Testosterone works with the dehydroepiandrosterone from the adrenal glands to stimulate the production of DHT (dihydrotestosterone) by the prostate gland. Inhibiting the production of testosterone this way therefore works to an acceptable degree. There are however less invasive ways of carrying out testosterone therapy for a patient. The use of GnRH (gonadotropine releasing hormone) agonists or GnRH antagonists also works well enough.

The antagonists prevent the release of FSH (follicle stimulating hormone) and luteinizing hormone (LH) from the pituitary gland, thereby blocking spermatogenesis (and thus the production of testosterone) in men. GnRH agonists work in a similar fashion, forcing an increased production of the hormones that the body cannot sustain until the production crashed.

Even after prostate cancer surgery, testosterone (hormonal) therapy is by no means a cure for cancer of the prostate because cancerous tumors usually grow resistant to the treatment after about a year or two. Other therapies may then need to be included in the regimen to best aid the recovery of the patient, unless the cancer is too far-gone and all that can be hoped for is the best of radiation.

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