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IMPORTANT SAFETY INFORMATION1
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IMPORTANT SAFETY INFORMATION1
LUPRON DEPOT® is not for people who have had any type of allergic reaction to LUPRON DEPOT or similar drugs. LUPRON DEPOT causes an increase in testosterone during the first few weeks of therapy.
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When To Consider Hormone Therapy
Hormone therapy is a treatment option for men with prostate cancer in any of the following situations:
- when cancer has metastasized beyond the prostate
- when cancer is confined to the prostate, but hormone therapy is used to boost the effectiveness of radiation therapy or to shrink the size of a tumor before brachytherapy
- when PSA begins to rise sometime after initial treatment with surgery or radiation therapy, indicating the cancer may have recurred.
Not all doctors agree on when to use hormone therapy, or how to administer it. Indeed, this is an area that requires a physician to exercise as much art as science in clinical practice. You should also be aware that side effects can be daunting, although most men tolerate treatment reasonably well .
Side Effects Of Lupron Injections For Prostate Cancer
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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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Lupron Treatment Duration: How Long Were You On It
I have been diagnosed with Grade 3 prostate cancer with a 4 + 3 Gleason score of 7. This after having 2 PSA scores last year between 4 and 7. The cancer has not spread to the bones. I have received two Lupron injections 3 months apart and will complete 28 radiation treatments in the next couple of days. No surgery. I have tolerated the Lupron shots well with few but manageable side effects. I have an appointment to receive a third Lupron shot next month. My first PSA test after completing radiation wont be scheduled for 3 months. From researching Lupron, it appears that this is used for advanced stages of prostate cancer. From what I was led to believe, I was not advanced. My question: How long and how many Lupron shots might I need to go through? I will have this discussion with my urologist hopefully before proceeding with the next shot. Thanks for any information provided by the group.
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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.
Hormone Therapy With Radiation
Hormone therapy is often given together with radiation therapy for localized disease .
Hormone therapy usually consists of a shot that lowers your testosterone, given every 1 to 6 months, depending on the formulation. Sometimes, it is prescribed as a daily pill that blocks testosterone from reaching the cancer cells. Clinical trials show a benefit in patients who receive hormonal treatment in combination with external beam radiation. Hormone therapy has been shown to improve cure rates of prostate cancer for men receiving radiation therapy and is part of the standard of care for men with certain types of intermediate-risk prostate cancer and nearly all high-risk prostate cancer. It is often given for intermediate-risk cancer for 4 to 6 months , and for 2 to 3 years in men with high-risk localized prostate cancer, although some doctors may recommend as little as 18 months of hormone therapy.
Hormone therapy should not be given to men with low-risk prostate cancer and is not a standalone treatment for localized prostate cancer in any risk category.
Want more information about a prostate cancer diagnosis and treatment options? Download or order a print copy of the Prostate Cancer Patient Guide.
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Options In Hormone Therapy
Testosterone levels in the body can be reduced either surgically or with drugs. The surgical option is castration, achieved by removing the testicles during a bilateral orchiectomy. Once the only option, it has since been supplanted by drugs that lower testosterone levels to amounts achieved by surgery.
For men, normal testosterone levels range from 300 to 1,000 ng/dl. The FDA requires that any new drug used in hormone therapy for prostate cancer lower testosterone levels to 50 ng/dl or less. In my practice, I usually try to lower levels even further, to 20 ng/dl.
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How To Use Lupron Solution
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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Quality Of Life On Hormone Therapy
Here, Id like to make 2 quick points. First, Id like to mention the general quality of life for those who are taking Lupron. If youre not having any side effects and your PC treatment is working, that is excellent news. If youre suffering from side effects of Lupron, how is your overall quality of life? While the medication is doing its job, is it makingyour life miserable? From what I have read about Lupron from the men on this site, something is not right. Yesthis medication is saving your life but at what cost?
Secondly, with any medication, you should ask the doctor to tell and explain the side effects. Most medications come with the fold-out sheet, written in 2-font, that is tough on the eyes to read and comprehend, which explains all the side effects. You should ask the doctor about the major side effects and what said medication will do to various aspects of your life . This way, you can make an informed decision and ask about other available treatments.
Removing a piece of a mans sexuality can have major mental and physical repercussions, including an effect on his relationship and lover. From reading the comments here, I read too many times where the lover didnt want to stay with a man who cannot perform sexually. Treating cancer is one thing, losing a is another.
Systemic Therapy For Metastatic Disease
The most common use of hormone therapy today is to treat men whose prostate cancer has metastasized to other parts of the body. If prostate cancer cells escape the prostate, they migrate first to surrounding structures, such as the seminal vesicles and lymph nodes, and later to the bones or, rarely, to other soft tissues.
Hormone therapy is recommended as a palliative treatment, to relieve symptoms such as bone pain. And while hormone therapy is not a cure, in that it cant eliminate prostate cancer completely, it often extends life for many years. By reducing testosterone levels, hormone therapy can shrink a prostate tumor and its metastases and slow further progression of the cancer for so long that sometimes a man with this disease dies of something other than prostate cancer.
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Efficacy And Safety Of Leuprolide Acetate 225 Mg Depot In Treatment Of Prostate Cancer
| The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. |
| First Posted : August 12, 2011Results First Posted : January 18, 2017Last Update Posted : March 3, 2017 |
| Drug: Leuprolide acetate 22.5 mg depot, GP-Pharm SA | Phase 3 |
| Study Type : | |
| Treatment | |
| Official Title: | Efficacy and Safety of a New Leuprolide Acetate 22.5 mg Depot Formulation in the Treatment of Prostate Cancer |
| Study Start Date : |
| Experimental: Leuprolide acetate 22.5 mg depotLeuprolide acetate 22.5 mg depot administered twice, 3 months apart | Drug: Leuprolide acetate 22.5 mg depot, GP-Pharm SAAdministered by im injection, twice during the study, three months apart |
The WHO/ECOG, bone pain, urinary pain and urinary symptoms data reported are the most frequent percentage at the assessment time.
Drugs That Stop Androgens From Working
Anti-androgens
For most prostate cancer cells to grow, androgens have to attach to a protein in the prostate cancer cell called an androgen receptor. Anti-androgens are drugs that also connect to these receptors, keeping the androgens from causing tumor growth. Anti-androgens are also sometimes called androgen receptor antagonists.
Drugs of this type include:
They are taken daily as pills.
In the United States, anti-androgens are not often used by themselves:
- An anti-androgen may be added to treatment if orchiectomy or an LHRH agonist or antagonist is no longer working by itself.
- An anti-androgen is also sometimes given for a few weeks when an LHRH agonist is first started. This can help prevent a tumor flare.
- An anti-androgen can also be combined with orchiectomy or an LHRH agonist as first-line hormone therapy. This is called combined androgen blockade . There is still some debate as to whether CAB is more effective in this setting than using orchiectomy or an LHRH agonist alone. If there is a benefit, it appears to be small.
- In some men, if an anti-androgen is no longer working, simply stopping the anti-androgen can cause the cancer to stop growing for a short time. This is called the anti-androgen withdrawal effect, although it is not clear why it happens.
Newer anti-androgens
Enzalutamide , apalutamide and darolutamide are newer types of anti-androgens. They can sometimes be helpful even when older anti-androgens are not.
These drugs are taken as pills each day.
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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.
What Are The Side Effects Of Hormone Therapy For Prostate Cancer
Because androgens affect many other organs besides the prostate, ADT can have a wide range of side effects , including:
- loss of interest in sex
Studer UE, Whelan P, Albrecht W, et al. Immediate or deferred androgen deprivation for patients with prostate cancer not suitable for local treatment with curative intent: European Organisation for Research and Treatment of Cancer Trial 30891. Journal of Clinical Oncology 2006 24:18681876.
Zelefsky MJ, Eastham JA, Sartor AO. Castration-Resistant Prostate Cancer. In: Vincent T. DeVita J, Lawrence TS, Rosenberg SA, eds. DeVita, Hellman, and Rosenberg’s Cancer: Principles & Practice of Oncology, 9e. Philadelphia, PA: Lippincott Williams & Wilkins 2011.
Smith MR, Saad F, Chowdhury S, et al. Apalutamide and overall survival in prostate cancer. European Urology 2021 79:150158.
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How Lupron Depot Is Given
LUPRON DEPOT is a prescription medicine that must be administered under the supervision of a physician. Its given as a single intramuscular injection, which means it is injected into one of your muscles, instead of under the skin or into a vein. Your doctor will determine the most appropriate injection site for you.1
Restoring Sexual Function After Lupron/cancer Treatment
Facts about Prostate Cancer: Prostate cancer is a highly prevalent disease afflicting one in five American men. It is the most commonly diagnosed cancer in men and the second leading cause of cancer death after lung cancer. Treatments for localized prostate cancer include: Observation, Surgery and Radiation therapy ± androgen ablation. Treatments for advanced prostate cancer: Androgen ablation and Chemotherapy
Facts About Lupron, Zoladex: Lupron/Zoladex are synthetic GnRH agents which means that these agents mimic the messages made by the hypothalamus to stimulate the pituitary. Initially there is a burst of LH/FSH and elevation of testosterone ultimately, there is absent LH/FSH and therefore absent testosterone synthesis. Lupron/Zoladex are very effective agents stopping testicle biosynthesis of testosterone. Blood levels of testosterone fall below the reference values. Example: Pre-Lupron/Zoladex Testosterone 450 . Post-Lupron/Zoladex Testosterone 50 .
Therapies utilized for men who develop ED after treatment for prostate cancer:
MUSE/Intracavernosal therapy: MUSE and Caverject are both FDA approved for ED treatment and are more likely to be effective if the cause of the ED is disrupted erection nerve integrity. Side effects include penile pain and poor efficacy. Other intracavernosal agents may be used when Caverject is either not tolerated or not effective. Such alternative agents include papaverine and phentolamine and papaverine, phentolamine and PGE 1 .
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