Wednesday, February 1, 2023

Effects Of Lupron For Prostate Cancer

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The Grade Group And Psa Level Are Used To Stage Prostate Cancer

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The stage of the cancer is based on the results of the staging and diagnostic tests, including the prostate-specific antigen test and the Grade Group. The tissue samples removed during the biopsy are used to find out the Gleason score. The Gleason score ranges from 2 to 10 and describes how different the cancer cells look from normal cells under a microscope and how likely it is that the tumor will spread. The lower the number, the more cancer cells look like normal cells and are likely to grow and spread slowly.

The Grade Group depends on the Gleason score. See the General Information section for more information about the Gleason score.

  • Grade Group 1 is a Gleason score of 6 or less.
  • Grade Group 2 or 3 is a Gleason score of 7.
  • Grade Group 4 is a Gleason score 8.
  • Grade Group 5 is a Gleason score of 9 or 10.

The PSA test measures the level of PSA in the blood. PSA is a substance made by the prostate that may be found in an increased amount in the blood of men who have prostate cancer.

When Is Hormone Therapy Used

Hormone therapy may be used:

  • If the cancer has spread too far to be cured by surgery or radiation, or if you cant have these treatments for some other reason
  • If the cancer remains or comes back after treatment with surgery or radiation therapy
  • Along with radiation therapy as the initial treatment, if you are at higher risk of the cancer coming back after treatment
  • Before radiation to try to shrink the cancer to make treatment more effective

What Types Of Hormone Therapy Are Used For Prostate Cancer

Hormone therapy for prostate cancer can block the production or use of androgens . Currently available treatments can do so in several ways:

  • reducing androgen production by the testicles
  • blocking the action of androgens throughout the body
  • block androgen production throughout the body

Treatments that reduce androgen production by the testicles are the most commonly used hormone therapies for prostate cancer and the first type of hormone therapy that most men with prostate cancer receive. This form of hormone therapy includes:

Treatments that block the action of androgens in the body are typically used when ADT stops working. Such treatments include:

Treatments that block the production of androgens throughout the body include:

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Sample Description And Compliance

During the study period, 71 patients were recruited, and 55 patients completed the questionnaires at 3, 6, and 12 months. A total of 22 patients underwent IMRT from the 3-month time point. All patients were administered 45 mg of leuprolide acetate every 6 months for 12 months, and the serum testosterone levels effectively decreased. The patients and treatment characteristics are summarized in Table 1. The mean age of the patients was 76.3 years, and the mean PSA level was 35.7 ng/mL . According to the clinical stage, 8 , 42 , and 5 patients had clinical stage T2, T3, and T4 disease, respectively. The number of patients with metastatic lymphadenopathy and bone metastasis was 6 and 7 , respectively. At 12 weeks, 55 patients achieved serum testosterone levels within the castration range, and the levels were maintained in this range even after 12 months . Mortality was not reported during the study period.

Longitudinal Effects In Patients Treated With Adt

Pin on Prostate Cancer

There was no statistically significant deterioration in the global health status/QOL based on the results of the EORTC QLQ-C30 . Among the functional scales, deterioration was noted in the physical function at 3, 6, and 12 months and in the role function at 3 and 12 months . The symptom scales of the EORTC QLQ-C30 indicated that fatigue and dyspnea were aggravated at 12 months . The responses to the QLQ-PR25 revealed that the patients experienced an increase in hormonal treatment-related symptoms at 3, 6, and 12 months .

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What Is Hormone Therapy

Hormones occur naturally in your body. They control the growth and activity of normal cells. Testosterone is a male hormone mainly made by the testicles.

Prostate cancer usually depends on testosterone to grow. Hormone therapy blocks or lowers the amount of testosterone in the body.

Hormone therapy on its own doesn’t cure prostate cancer. But it can lower the risk of an early prostate cancer coming back when you have it with other treatments. Or it can shrink an advanced prostate cancer or slow its growth.

Study Design And Population

This prospective longitudinal cohort study included newly diagnosed patients with PC and was conducted between October 2018 and April 2020 at Chonnam National University Hwasun Hospital. The inclusion criteria were as follows: pathological diagnosis of a high risk or very high risk of PC, advanced-stage PC, or metastatic PC and prescription of ADT alone or ADT with intensity-modulated radiation therapy . All patients who already had received hormonal treatment for PC or had a double primary cancer before or after the diagnosis of PC were excluded. Other exclusion criteria were refusal to participate in the study or communication difficulties. All patients received subcutaneous injections of 45 mg leuprolide acetate at 6-month intervals for 12 months and 50 mg of an antiandrogen orally daily. Concurrent IMRT was performed from 3 months after the start of neoadjuvant ADT. All patients provided written informed consent and completed a self-administered questionnaire before administration of ADT and at 3, 6, and 12 months. The study protocol was approved by the Institutional Review Board of Chonnam National University Hwasun Hospital , and the study was conducted in accordance with the guidelines of the Declaration of Helsinki.

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How Effective Is It For The Treatment Of Prostate Cancer

Male hormones give prostate cancer cells the fuel they need to grow and spread. The goal of hormone treatments, such as Lupron, is to deprive cancer cells of this fuel to slow disease progression. That said, Lupron is not a cure for prostate cancer. Rather, it works to slow down the growth and spread of the cancer.

Lupron can be used to treat any stage of prostate cancer, but its usually used for recurrent or advanced cancers. In men with early-stage prostate cancer who dont want surgery or radiation, there is no evidence that hormone therapy is more effective than watchful waiting or active surveillance, according to the .

How To Use Lupron Solution

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Read the Medication Guide and, if available, the Patient Information Leaflet provided by your pharmacist before you start using leuprolide and each time you get a refill. If you have any questions, ask your doctor or pharmacist.

This medication is given by injection under the skin as directed by your doctor, usually once a day.

In children, the dosage is based on weight and response to treatment. The doctor should consider stopping treatment before age 11 for girls and age 12 for boys. Consult the doctor for details.

If you are using this medication at home, learn all preparation and usage instructions from your health care professional and the product package. Learn how to store and discard medical supplies safely.

Before using, check this product visually for particles or discoloration. If either is present, do not use the liquid. Before injecting each dose, clean the injection site with rubbing alcohol. Change the injection site each time to lessen injury under the skin.

Use this medication regularly to get the most benefit from it. To help you remember, use it at the same time each day.

During the first few weeks of treatment, your hormone levels will actually go up before they go down. This is a normal response to this medication. Your symptoms may get worse for a few weeks.

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Early Versus Delayed Treatment

For men who need hormone therapy, such as men whose PSA levels are rising after surgery or radiation or men with advanced prostate cancer who dont yet have symptoms, its not always clear when it is best to start hormone treatment. Some doctors think that hormone therapy works better if its started as soon as possible, even if a man feels well and is not having any symptoms. Some studies have shown that hormone treatment may slow the disease down and perhaps even help men live longer.

But not all doctors agree with this approach. Some are waiting for more evidence of benefit. They feel that because of the side effects of hormone therapy and the chance that the cancer could become resistant to therapy sooner, treatment shouldnt be started until a man has symptoms from the cancer. This issue is being studied.

Hormone Therapy For Prostate Cancer

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Hormone therapy is also called androgen suppression therapy. The goal of this treatment is to reduce levels of male hormones, called androgens, in the body, or to stop them from fueling prostate cancer cell growth.

Androgens stimulate prostate cancer cells to grow. The main androgens in the body are testosterone and dihydrotestosterone . Most androgens are made by the testicles, but the adrenal glands as well as the prostate cancer cells themselves, can also make androgens.

Lowering androgen levels or stopping them from getting into prostate cancer cells often makes prostate cancers shrink or grow more slowly for a time. But hormone therapy alone does not cure prostate cancer.

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After Prostate Cancer Has Been Diagnosed Tests Are Done To Find Out If Cancer Cells Have Spread Within The Prostate Or To Other Parts Of The Body

The process used to find out if cancer has spread within theprostate or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. The results of the tests used to diagnoseprostate cancer are often also used to stage the disease. In prostate cancer, staging tests may not be done unless the patient has symptoms or signs that the cancer has spread, such as bone pain, a high PSA level, or a high Gleason score.

The following tests and procedures also may be used in the staging process:

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Treatment By Stage Of Prostate Cancer

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Different treatments may be recommended for each stage of prostate cancer. Your doctor will work with you to develop a specific treatment plan based on the cancers stage and other factors. Detailed descriptions of each type of treatment are provided earlier on this same page. Clinical trials may also be a treatment option for each stage.

Early-stage prostate cancer

Early-stage prostate cancer usually grows very slowly and may take years to cause any symptoms or other health problems, if it ever does at all. As a result, active surveillance or watchful waiting may be recommended. Radiation therapy or surgery may also be suggested, as well as treatment in clinical trials. For those with a higher Gleason score, the cancer may be faster growing, so radical prostatectomy and radiation therapy are often recommended. Your doctor will consider your age and general health before recommending a treatment plan.

ASCO, the American Urological Association, American Society of Radiation Oncology, and the Society of Urologic Oncology recommend that patients with high-risk early-stage prostate cancer that has not spread to other areas of the body should receive radical prostatectomy or radiation therapy with hormonal therapy as standard treatment options.

Locally advanced prostate cancer

Watchful waiting may be considered for older adults who are not expected to live for a long time and whose cancer is not causing symptoms or for those who have another, more serious illness.

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Eligard Vs Lupron Depot: Which Is More Effective Against Prostate Cancer

There isnt much research available comparing these medications directly. But we can look at how well each medication lowers testosterone levels.

The goal with medications like leuprolide is to lower testosterone levels below 50 ng/dL. In Eligards clinical trials, over 94% of participants achieved this goal within about a month of their first injection. Similarly, about 94% of people in Lupron Depots clinical trials reached the goal level within the first month.

Based on this information, we can say Eligard and Lupron Depot are comparable.

How Is Castration

  • Complete androgen blockadethat is, androgen receptor blockers .
  • Androgen synthesis inhibition with abiraterone.
  • Immunotherapy using a cell-based vaccine called sipuleucel-T . This vaccine uses a mans own immune cells to fight metastatic prostate cancer that has few or no symptoms.
  • Chemotherapy, most commonly with the drug docetaxel. Another drug, cabazitaxel , is approved for the treatment of metastatic castration-resistant prostate cancer that was previously treated with docetaxel.
  • Radium-223 dichloride , a radiopharmaceutical that collects in areas of bone that are undergoing increased turnover , such as where bone metastases are forming, and gives off radiation that kills cancer cells.
  • Drugs that inhibit an enzyme called PARP, which helps repair DNA when it becomes damaged. Two PARP inhibitors, rucaparib camsylate and olaparib , are used to treat castration-resistant prostate cancers that have certain mutations.

Men with castration-resistant prostate cancer who receive these treatments will continue to receive ADT to keep testosterone levels low, because an increase in testosterone could lead to tumor progression in some men .

Randomized clinical trials in men with metastatic castration-resistant prostate cancer have shown improved survival among men receiving abiraterone or enzalutamide in addition to ADT compared with those receiving ADT alone, whether or not they have previously received chemotherapy .

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How Does It Work

The class of drugs to which Lupron belongs speaks a lot about its mechanism of action. Leuprolide acetate works to suppress gonadotrope secretion of follicle-stimulating and luteinizing hormone . This action eventually inhibits gonadal sex steroid production.

A more detailed explanation would be the following.

At first, administration of Lupron stimulates pituitary gland gonadotropins luteinizing hormone, and follicle-stimulating hormone .

As a result, steroidogenesis in a mans testicles increases.

When that happens, men may have elevated serum testosterone and dihydrotestosterone levels.

This is called tumor flare when the initial stages of treatment worsen symptoms of the disease.

That said, continuous administration of Lupron decreases gonadotropins and gonadal steroids.

With time, consistent administration of leuprolide acetate lowers the concentration of serum testosterone levels by inhibiting LH and FSH.

Before Taking This Medicine

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You should not use Lupron Depot if you are allergic to leuprolide or similar medicines such as buserelin, goserelin, histrelin, nafarelin, or if you have abnormal vaginal bleeding that has not been checked by a doctor.

Lupron Depot can cause birth defects. Do not use if you are pregnant. Tell your doctor right away if you become pregnant.

Certain brands or strengths of leuprolide are used to treat only men and should not be used in women or children. Always check your medicine to make sure you have received the correct brand and strength. Ask the pharmacist if you have any questions about the medicine you receive at the pharmacy.

To make sure Lupron Depot is safe for you, tell your doctor if you have ever had:

Do not give this medicine to any child without medical advice.

Lupron Depot usually causes women to stop ovulating or having menstrual periods. However, you may still be able to get pregnant. Use a condom or diaphragm with spermicide to prevent pregnancy. Lupron Depot can make hormonal birth control less effective .

You should not breast-feed while using Lupron Depot.

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Symptomatic treatment of an enlarged prostate usually involves a combination of medication and lifestyle changes. A diet rich in fruits and vegetables may be the best option if you suffer from chronic urination. It will help the body adjust to the increased size of the prostate. Also, taking regular urination intervals will help retrain the bladder to function properly. Inactivity also contributes to urine retention, and cold temperatures can increase the urge to urinate.

Invasive treatment of enlarged prostate includes medication that relieves the pressure on the urethra and bladder. However, if the condition is severe, it may require surgical intervention. If treatment is not successful, the enlarged prostate can become a potentially life-threatening disease. As the hormone levels in the body change, the enlarged prostate can lead to various complications, including urinary retention and even cancer. This is why it is critical to see a doctor for further evaluation.

Measures Of The Hrqol

In our study, HRQOL was the primary outcome. The HRQOL was assessed before treatment and at 3, 6, and 12 months after treatment using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 and an accompanying PC-specific module . The Korean version of the EORTC QLQ-C3012,13 and its prostate module 14,15 were used in this study. The EORTC QLQ-C30 is a 30-item scoring scale for global QOL, while the PR25 comprises 25 questions in 6 domains. The PR25 was designed to evaluate QOL associated with PC. All 55 questions were regrouped into 21 scales. On all scales, the item scores were summed and converted linearly to scale scores ranging from 1 to 100. A higher score on the functional scale indicates a higher level of function, but a higher score on the symptom scale indicates more severe symptoms. The domain scores for the QLQ-C30 and PR25 modules were calculated according to the scoring manual provided by the EORTC QOL group.12,14 We also collected patient data, including sociodemographic characteristics, such as marital status, education level, and smoking and drinking status. Clinical data, including the tumor, node, metastasis stage, Gleason score, Karnofsky performance status, and initial prostate-specific antigen levels, were assessed.

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