How Is Hormone Therapy Used To Treat Hormone
Hormone therapy may be used in several ways to treat hormone-sensitive prostate cancer, including:
Early-stage prostate cancer with an intermediate or high risk of recurrence. Men with early-stage prostate cancer that has an intermediate or high risk of recurrence often receive hormone therapy before, during, and/or after radiation therapy, or after prostatectomy . Factors that are used to determine the risk of prostate cancer recurrence include the grade of the tumor , the extent to which the tumor has spread into surrounding tissue, and whether tumor cells are found in nearby lymph nodes during surgery.
The use of hormone therapy before prostatectomy has not been shown to be of benefit and is not a standard treatment. More intensive androgen blockade prior to prostatectomy is being studied in clinical trials.
Relapsed/recurrent prostate cancer. Hormone therapy used alone is the standard treatment for men who have a prostate cancer recurrence as documented by CT, MRI, or bone scan after treatment with radiation therapy or prostatectomy.
Hormone therapy is sometimes recommended for men who have a biochemical recurrencea rise in prostate-specific antigen level following primary local treatment with surgery or radiationespecially if the PSA level doubles in fewer than 3 months.
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Who Is At Risk
All men are at risk for prostate cancer, and
about 1 in 8 men
will develop prostate cancer in their lifetime. Of those developing prostate cancer, approximately 21% will be diagnosed with advanced prostate cancerAdvanced prostate cancerA tumor that has spread outside of the prostate to other areas of your body is considered to be advanced prostate cancer. Your doctor will perform tests in order to confirm that you have advanced prostate cancer. Men with advanced prostate cancer may have no symptoms.
Black American men
- Nearly 2x more likely to be diagnosed with prostate cancer compared with White American men
- The death rate from prostate cancer in Black American men is twice as high as in White American men
- Black American men should be given information about prostate cancer screening so that they can have discussions with their doctors at an earlier age than other men
Age is the most common risk factor, and the older you are, the greater the risk of developing prostate cancer.
Men aged 50 and over
who are at average risk of prostate cancer and have a life expectancy of at least 10 years should:
- Receive information about the potential benefits and known limitations of testing for early prostate cancer detection
- Be given the opportunity to make an informed decision about testing
Men with a family history of prostate cancer
may be at higher risk, so its important to talk to your doctor about your familys health history. Men aged 50 and over
Let’s Go Over Some Basics Of Lupron And Why It Would Be Prescribed To You
So for the purpose of this post, Im gonna talk about Lupron in the context of prostate cancer. Now, Im picking Lupron because that is what Dr. Jafris office has but there are many cousins of Lupron and your urologist may prescribe a different shot. These are all in the class of LHRH agonists.
Lupron is a shot that you get in the office. The purpose of this shot is to lower testosterone levels in the body and comes in different formulations that can be given at 1 month, 3 month, 4 month, or even 6 month intervals.
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Eligard For Prostate Cancer
The Food and Drug Administration approves prescription drugs such as Eligard to treat certain conditions. Eligard may also be used off-label for other conditions. Off-label drug use means using a drug for a purpose other than what its been approved for by the FDA.
Eligard is approved for use as a palliative treatment for advanced prostate cancer in adult males*. Palliative treatment means that the drug works to help manage pain and other symptoms of this condition. It wont treat or cure advanced prostate cancer, but it may help improve a persons quality of life.
* Use of the terms male and female within this article refers to a persons sex assigned at birth.
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.
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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 .
Table : Survival Benefits Of Early Treatment
An analysis of 98 men with prostate cancer that had spread to the lymph nodes, who were randomly assigned to receive immediate hormone therapy or to forgo it until the disease spread further to bones or lungs, found that early treatment saved lives.
Deaths from prostate cancer 21 Source: Lancet Oncology 2006 7:4729. PMID: 16750497.
Other studies have shown that starting hormone therapy early on increases survival times, delays cancer progression, and results in better quality of life. However, in a review of four studies involving 2,167 men with metastatic prostate cancer, the Cochrane Collaboration concluded that early hormone therapy had offered only a small overall survival advantage over deferred treatment, and cautioned that more research on the issue needs to be done.
Although debate on this issue continues, in most cases I advise my patients with metastatic disease to begin hormone treatment early on. This is particularly important for someone with spine metastases, because a bone fracture or extension of the cancer into the spinal cord area could lead to impaired mobility and even paralysis. Fortunately, this is a rare event.
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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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Drugs Used With Lupron Depot For Palliative Treatment Of Advanced Prostate Cancer
When treating advanced prostate cancer, Lupron Depot is often used with other drugs to reduce the risk of a tumor flare. These drugs are called anti-androgen medications.
Lupron Depot works by stopping your body from making certain hormones, like testosterone. When you first start taking Lupron Depot, your body may respond by producing too much testosterone. This can have negative side effects such as bone pain and paralysis. Lowering the risk of a testosterone flare can help lower your risk for these side effects.
Anti-androgen medications can be given with Lupron Depot or before you start Lupron Depot. Examples of these medications include bicalutamide , nilutamide , and flutamide .
Here are answers to some frequently asked questions about Lupron Depot.
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Research Data Missing For Decades Raise Concerns On Morning Sickness Drug
Adverse event reports are effective at flagging simple conditions that doctors recognize as an immediate consequence of taking a drug, such as vomiting or nausea. They are less prone to be filed and less effective at identifying longer-range problems, according to critics of the FDAs oversight of approved drugs.
As a parent, I kick myself, says Jeanne Walsh, a Temecula, Calif., resident who filed an adverse event report years ago, as did several other mothers interviewed recently for this story because their children took Lupron. Walshs daughter took Lupron for precocious puberty and now struggles with fibromyalgia and has had jaw-joint surgery. What was I thinking?
In 1999, the FDA examined 6,000 adverse-event reports about Lupron filed by doctors, patients, and researchers. Although the FDA couldnt locate its 1999 report on the matter, a court document that summarized the findings of the report said it found high prevalence rates for serious side effects including depression, joint pain, and weakness, and noted similar effects in men and women with very different ailments suggested the drug was causing the problems rather than underlying medical conditions.
The FDA made no major change, but reviewed the drug labels to determine whether the side effects were covered.
The settlement resulted in a corporate guilty plea for conspiracy to violate prescribing laws and one of the largest fines at the time $875 million.
Intermittent Or Continuous Therapy
Once prescribed, hormone therapy used to continue for life, but scientists are now reevaluating that strategy and investigating whether hormone therapy can be taken intermittently, with so-called holidays from treatment. The thinking is that this may not only help restore quality of life as, for example, returning libido and sexual health but also delay the hormone resistance that eventually develops in men taking hormone therapy.
Clinical trials evaluating whether intermittent therapy is as effective or more effective than continuous therapy are now under way, so it is too early to say for sure.
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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.
Enhancing Healthcare Team Outcomes
Sex-hormone related disorders present with more than just the physiological findings to treat. For instance, precocious puberty not only shows as physical changes but also has mental effects on a child and how they are perceived in the world. Therefore, an interprofessional team of healthcare providers is necessary to treat these patients. These interprofessional teams should include physicians, nurses, pharmacists, psychologists, and others. The same applies to an interprofessional team that will treat patients with advanced prostate cancer. When the clinician or specialist initiates leuprolide therapy, a pharmacist should perform drug interaction checking and verify the dosage. Nursing can counsel the patient regarding dosing and administration, as well as potential adverse events that will require them to contact the prescriber’s office. Pharmacists and nurses need to notify the clinicians if they have any concerns about the patient’s therapy, as this type of interprofessional interaction will improve patient outcomes.
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Will Trelstar Lower My Testosterone Level
Yes, it will. One of the primary goals of prostate cancer treatment is to lower peoples testosterone level. This is because prostate cancer grows and spreads when its exposed to testosterone. When testosterone levels are reduced, prostate cancer tumors may shrink in size or even go away completely. This in turn helps to relieve symptoms of the condition.
In clinical studies, Trelstar was found effective in lowering testosterone levels in people with advanced prostate cancer. See the section Trelstar Uses above for more details.
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A Doctor May Prescribe Hormone Therapy For Advanced Prostate Cancer:
- 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 or abnormal tissue . Since prostate tumors are often made up of cancerous cells that have different grades, two grades are assigned for each patient. A primary grade is given to describe the cells that make up the largest area of the tumor and a secondary grade is given to describe the cells of the next largest area. For instance, if the Gleason Score is written as 3+4=7, it means most of the tumor is Grade 3 and the next largest section of the tumor is Grade 4, together they make up the total Gleason Score. Typical Gleason Scores range from 6-10. The higher the Gleason Score, the more likely that the cancer will grow and spread quickly. , high PSA level, and/or growth of the cancer outside the prostate)
- Before radiation, to try and make treatment more effective
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Is Eligard A Chemotherapy Drug
No, Eligard isnt a chemotherapy drug. Chemotherapy drugs work throughout the body to decrease the number of cancer cells a person has. However, because chemotherapy drugs work throughout a persons body, they often have many side effects.
Eligard is a type of hormone therapy. It works by decreasing the amount of testosterone that you have. Testosterone helps prostate cancer cells grow. Therefore, decreasing the amount of testosterone that you have decreases the growth of your prostate cancer. This in turn helps decrease symptoms caused by the cancer.
For more on how Eligard helps to manage symptoms of advanced prostate cancer, see the How Eligard works section below. If you have additional questions about how Eligard works, talk with your doctor.
* Use of the terms male and female within this article refers to a persons sex assigned at birth.
Why Would I Need Lupron If There Are Signs Of Prostate Cancer Spread Or Metastasis
In the last instance, there has been documented signs of prostate cancer spread. This is termed metastatic prostate cancer. There have been loads of new treatments that are now available to treat this.
However, the backbone of all those treatments includes the use of Lupron shots. Sometimes, the Lupron shots will be given alone, but now, most of the time, we will give the Lupron in combination with some other treatment.
There are many patients who have been on Lupron and the PSA has started to climb and/or there are signs of spread that have developed. Even if you are started on other treatment, we will still continue the Lupron. Now why is this? This is due to the fact that as mentioned above, Lupron is the backbone of all other treatments. Even though the cancer is not completely responding to the Lupron treatment, there is still a role for it as there are cancer cells that are being affected by the Lupron shot.
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