Androgen deprivation therapy

• Prostate Cancer

• Testosterone Synthesizing Process

Androgen Deprivation Therapy

Androgen deprivation therapy (ADT), also known as androgen suppression therapy, is a treatment primarily used in the management of prostate cancer. It involves reducing the levels of androgens, such as testosterone, which can stimulate the growth of prostate cancer cells.

Mechanism of Action

Androgens are male hormones that play a crucial role in male traits and reproductive activity. In the context of prostate cancer, androgens can promote the growth of cancerous cells. ADT works by either reducing the production of androgens or blocking their effects on the prostate cancer cells.

Methods of Androgen Deprivation

There are several methods to achieve androgen deprivation:

• Surgical castration: Also known as orchiectomy, this involves the surgical removal of the testes, which are the primary source of testosterone production.

• Medical castration: This involves the use of medications to lower androgen levels. These medications include:

 * Luteinizing hormone-releasing hormone (LHRH) agonists, such as leuprolide and goserelin, which initially increase and then decrease testosterone production.
 * LHRH antagonists, such as degarelix, which directly inhibit the release of luteinizing hormone and reduce testosterone levels.

• Anti-androgens: These are medications that block the action of androgens on their receptors. Examples include bicalutamide, flutamide, and enzalutamide.

Indications

ADT is primarily indicated for:

• Advanced or metastatic prostate cancer, where the cancer has spread beyond the prostate gland.
• As an adjuvant therapy in combination with radiation therapy for high-risk localized prostate cancer.
• In cases of biochemical recurrence, where there is a rise in prostate-specific antigen (PSA) levels after initial treatment.

Side Effects

The reduction of androgen levels can lead to several side effects, including:

• Hot flashes
• Loss of libido
• Erectile dysfunction
• Osteoporosis and increased risk of fractures
• Muscle loss and weight gain
• Fatigue
• Mood changes and depression

Monitoring and Management

Patients undergoing ADT require regular monitoring to assess the effectiveness of the therapy and manage side effects. This includes:

• Regular measurement of PSA levels to monitor cancer progression.
• Bone density scans to assess the risk of osteoporosis.
• Lifestyle modifications and medications to manage side effects such as bone loss and cardiovascular risks.

Related Pages

• Prostate cancer
• Testosterone
• Hormone therapy
• Radiation therapy