Prostate Cancer Treatment

Treatment of advanced prostate cancer

In advanced states of prostate cancer, completely curing it is no longer possible, so the object of treatment is simply to slow down its progress.

For a discussion of treatments applicable to early forms of prostate cancer, follow this link: Localized Prostate Cancer

Hormone therapy

Prostate cancer is linked in a complex way to hormone secretions. Therefore treatments exist that suppress the production of certain hormones using appropriate drugs. They don't actually cure the cancer, rather they block it for periods ranging from several months to several years. The duration depends very much on the nature of the tumor and the body's sensitivity to the medication.

These hormone therapies (in reality, anti-hormone treatments) are used to treat locally developed cancer and also cancer with metastases, i.e. where the cancer has already developed beyond the curable stage. However, they are also occasionally given to patients with less developed cancer in the period leading up to an operation or radiotherapy.

At the beginning of the last century, prostate cancer was treated by surgical castration. After that, and up until quite recently, urologists used to remove the testicle pulp – the tissue that produces testosterone. Of course, the latter procedure was much less psychologically traumatizing than castration.

Actually, the drugs that are given do more or less the same thing as surgery in reducing testicular volume and have similar side-effects: hot flushes, weight gain, increase in fat around the hips and thighs, hair loss.

There are two basic types of medication:

LHRH analogs

LHRH (an abbreviation for Luteinizing Hormone-Releasing Hormone) is a hormone that regulates other hormones, particularly the hormone LH (Luteinizing Hormone), which brings about the synthesis of testosterone.

LHRH analogs bind to the pituitary gland taking the place of real LHRH, and completely arrest the production of LH. The result is the reduction in size of the testes and stopping of testosterone production. In this way the cancer cells also stop multiplying.

LHRH analogs are administered by injection, typically either once a month or quarterly.

Anti-androgens

Anti-androgens comprise molecules that work by fixing to all the androgen receptors throughout the entire body, including those of the prostate. This prevents the male hormones doing their job since their place is already occupied by this medication. Thus the cancerous cells can no longer be stimulated by the body's androgens and therefore cease to multiply.

LHRH analog and anti-androgen medications can be given either separately or in combination. Normally, once treatment is started, except under special circumstances, it is never stopped. As mentioned previously, however, they are occasionally given immediately prior to an operation or radiotherapy

Other medications

Estrogen-based medication, cortisone, products facilitating re-calcification of the bones, and chemotherapy are occasionally employed. But this is usually only in treating highly evolved forms of prostate cancer that might have become resistant to normal anti-hormone treatments.

Estrogen medication was once the primary form of hormone therapy for treating prostate cancer. It works by using the female hormone diethylstilbestrol (DES) to suppress testosterone production. It is typically taken in the form of pills one to three times a day. However, the use of estrogen has declined due to the potentially dangerous side effects, such as the risk of blood clots, strokes and heart disease.