Prostate Cancer: Medications

Drug treatment with hormones is mainly used to relieve symptoms of advanced prostate cancer.
It can often help improve symptoms, but it is not a cure.
It may be the only treatment given for prostate cancer that has spread to other parts of the body. It may help to prevent or relieve symptoms such as bone pain.
It may also be given before radiation therapy or surgery to remove the prostate (prostatectomy). There is some evidence that this improves the success of the surgery in removing all of the cancer.

Prostate cancer often needs the hormone testosterone to keep growing. Hormone therapy blocks the influence of testosterone on the prostate cancer cells, which often causes the cancer to get smaller (regress; which occurs in 50% of men) and symptoms to improve (which occurs in 80% of men) 8. Testosterone is produced in a man’s testes. Surgery to remove the testes (orchiectomy) is sometimes done to eliminate this source of testosterone.

Steroids, such as hydrocortisone or prednisone, may be used in men who have advanced cancer (which has spread to other parts of the body) to relieve pain, improve the appetite, and improve the man’s comfort.

Chemotherapy (use of drugs to kill cancer cells) has not been very useful in treating prostate cancer. Doctors are studying new drugs, hoping to find chemotherapy drugs that will be more effective in treating prostate cancer.

The drug finasteride (Proscar or Propecia no prescription) is being studied to see if it may be useful to both prevent and treat prostate cancer. Finasteride is presently used to treat symptoms of prostate enlargement (BPH) by reducing levels of a hormone that is also involved in the growth of prostate cancer. Results of the study will not be known for several years.

Options

Drugs that reduce the production of testosterone (LHRH agonists/GnRH agonists such as Lupron and Zoldex)
Drugs that block the action of testosterone (Antiandrogens such as Eulexin and Nelutamide)
Steroids (such as hydrocortisone or prednisone) may be used in advanced cases of cancer to control pain and improve the man’s comfort.

Considerations

Hormone therapy often affects a man’s sex drive, his ability to have an erection, and his ability to father children. These side effects may be unacceptable to some men. In the past, estrogen therapy was commonly used to treat prostate cancer. It is generally no longer used because of its adverse effect on the cardiovascular system, its side effect of hot flashes, and because better drugs have been developed.

Intermittent use of hormones to treat prostate cancer is being studied. In this treatment, periods of hormone treatment are alternated with periods of rest from hormone treatment. This may prove to be a good treatment approach, but the results of these studies will not be available for years.

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