Estramustine
A chemotherapy medication used in the treatment of prostate cancer
Estramustine is a chemotherapy medication primarily used in the treatment of prostate cancer. It is a combination of estradiol and nitrogen mustard, designed to target cancer cells by disrupting their growth and division. Estramustine is unique in its dual action as both a hormonal therapy and a cytotoxic agent.
Mechanism of Action[edit | edit source]
Estramustine works by combining the properties of estrogen and alkylating agents. The estrogen component helps in reducing the levels of testosterone, a hormone that can promote the growth of prostate cancer cells. The alkylating agent, derived from nitrogen mustard, interferes with the DNA replication process in cancer cells, leading to cell death.
Pharmacokinetics[edit | edit source]
Estramustine is administered orally and is absorbed in the gastrointestinal tract. Once in the body, it is metabolized into its active forms, estramustine and estradiol, which exert their effects on cancer cells. The drug is primarily excreted through the urine.
Clinical Use[edit | edit source]
Estramustine is indicated for the treatment of metastatic prostate cancer, particularly in cases where the cancer has become resistant to other forms of hormonal therapy. It is often used in combination with other chemotherapy agents to enhance its efficacy.
Side Effects[edit | edit source]
Common side effects of estramustine include nausea, vomiting, and diarrhea. Patients may also experience gynecomastia, edema, and hypertension. Due to its estrogenic activity, there is a risk of thromboembolic events, such as deep vein thrombosis and pulmonary embolism.
Contraindications[edit | edit source]
Estramustine is contraindicated in patients with a history of thromboembolic disorders, severe liver disease, or known hypersensitivity to the drug. It should not be used in pregnant or breastfeeding women due to potential harm to the fetus or infant.
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