Drawing from a national cancer register, they estimated that after 10 years prostate cancer would have killed less than three percent of these men.
With modern screening tests, said Lu-Yao, of the University of Medicine and Dentistry of New Jersey in New Brunswick, many prostate cancers are found that might never have developed into serious disease. In such cases, the slight reduction of risk by surgically removing the prostate or treating it with radiation may not outweigh the substantial side effects of these treatments.
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There are different types of hormone therapy available as injections or as pills that can be taken by mouth. Some of these therapies stop the body from producing luteinizing-hormone-releasing-hormone LHRH, also called gonadotrophin releasing hormone, or GnRH.
LHRH triggers the body to make testosterone. Other therapies stop prostate cells from being affected by testosterone by blocking hormone receptors.
Sometimes, after the first shot, a blood test is done. This is done to check testosterone levels. You may also have tests to monitor your bone density during treatment. With LHRH treatment there is no need for surgery. Candidates for this treatment include men who cannot or do not wish to have surgery to remove their testicles.
There are different types of medical hormone therapy your doctor could prescribe to lower your body's production of testosterone. After your testosterone levels drop to a very low level, you are at "castration level. They may be used for cancer that has come back, whether or not it has spread. When first given, agonists cause the body to produce a burst of testosterone called a "flare". Agonists are longer acting than natural LHRH.
As a result, the testicles are not stimulated to produce testosterone. Based on the drug used, they could be given from once every one, three or six months.
These drugs also lower testosterone. Antagonists may be taken by mouth or injected shot under the skin, in the buttocks or abdomen. The shot is given in the health care provider's office. You will likely stay in the office awhile after the shot to ensure there is no allergic reaction.
After the first shot, a blood test makes sure testosterone levels have dropped. You may also have tests to monitor bone density. Antiandrogen drugs are taken as a pill by mouth. This therapy depends partly on where the cancer has spread and its effects. This treatment lowers testosterone by inhibiting the androgen receptors in the prostate cancer cells. Normally, testosterone would bind with these receptors to fuel growth of prostate cancer cells.
With the receptors blocked, testosterone cannot "feed" the prostate. Using anti-androgens a few weeks before, or during, LHRH therapy may reduce "flare ups. This method blends castration by surgery or with the drugs described above and antiandrogen drugs. The treatment reduces production of testosterone and can help stop it from binding to cancer cells.
Surgery or taking oral drugs may be ways to lower the testosterone made by your testicles. The rest of the testosterone is made by the adrenal glands. Antiandrogen therapy blocks testosterone made by the adrenal glands. These drugs help stop other parts of your body and the cancer itself from making more testosterone and its metabolites.
Men newly diagnosed with metastatic hormone sensitive prostate cancer mHSPC or men with metastatic castration-resistant prostate cancer mCRPC may be good candidates for this therapy. Androgen synthesis inhibitors may be taken by mouth as a pill. This drug helps stop your body from releasing the enzyme needed to make androgens in the adrenal glands, testicles and prostate tissue, resulting in reduced levels of testosterone and other androgens.
Because of the way it works, this drug must be taken with an oral steroid. Unfortunately, hormone therapy may not work forever, and it does not cure the cancer. Over time, the cancer may grow in spite of the low hormone level. Other treatments are also needed to manage the cancer. Hormone therapies have many possible side effects.
Learn what they are. Intermittent not constant hormone therapy may also be a treatment option. Before starting any type of hormone therapy, talk with your health care provider. There are many benefits and risks to each type of hormone therapy, so ask questions of your doctor so you understand what is best for you. Chemotherapy drugs can slow the growth of cancer. These drugs may reduce symptoms and extend life.
Or they may ease pain and symptoms by shrinking tumors. Chemotherapy is useful for men whose cancer has spread to other parts of the body. Most chemotherapy drugs are given through a vein intravenous, IV. During chemotherapy, the drugs move throughout the body. They kill quickly growing cancer cells and non-cancer cells.
Often, chemotherapy is not the main therapy for prostate cancer. But it may be a treatment option for men whose cancer has spread. Chemotherapy may be given before pain starts as it may prevent pain as cancer spreads to bones and other sites. Side effects may include hair loss, fatigue, nausea and vomiting.
There may be changes in your sense of taste and touch. You may be more prone to infections. You may experience neuropathy tingling or numbness in the hands and feet. Due to the side effects from chemotherapy, the decision to use these drugs may be based on:. If you use chemotherapy, your health care team may watch you closely to manage side effects.
There are medicines to help with things like nausea. Most side effects stop once chemotherapy ends. It may be a choice for men with mCRPC who have no symptoms or only mild symptoms. If the cancer returns and spreads, your doctor may offer a cancer vaccine to boost your immune system so it can attack the cancer cells. Immunotherapy may be given to mCRPC patients before chemotherapy or it may be used along with chemotherapy.
Side effects are often in the first 24 hours after treatment and may include fever, chills, weakness, headache, nausea, vomiting and diarrhea. Patients may also have low blood pressure and rashes. SREs include fractures, pain and other problems.
If you have advanced prostate cancer or are taking hormone therapy, your provider may suggest calcium, Vitamin D or other drugs for your bones. Radiopharmaceuticals are drugs with radioactivity. They can be used to help with bone pain from metastatic cancer. Some may also be used for men whose mCRPC has spread to their bones. They may be offered when ADT is not working. Radiopharmaceuticals give off small amounts of radiation that go to the exact parts where cancer cells are growing.
Drugs used to reduce SREs may help reduce bone turnover. Side effects include low calcium, worsening kidney function and, rarely, destruction of the jawbone. Calcium and Vitamin D are also used to help protect your bones. They are often recommended for men on hormone therapy to treat prostate cancer. Radiation uses high-energy beams to kill tumors. Prostate cancer often spreads to the bones. Radiation can help ease pain or prevent fractures caused by cancer spreading to the bone.
There are many types of radiation treatments. Radiation may be given once or over several visits. Treatment is like having an x-ray. It uses high-energy beams to kill tumors. Some radiation techniques focus on saving nearby healthy tissue.
Computers and software allows better planning and targeting of radiation doses. They target the radiation to pinpoint where it is needed. Active surveillance is mainly used to delay or avoid aggressive therapy.
It is often used if you have a small, slow growing cancer. It may be a choice for men who do not have symptoms or want to avoid sexual, urinary or bowel side effects for as long as possible. Others may choose surveillance due to their age or overall health. This method may require you to have many tests over time to track cancer growth.
This lets your doctor know how things are going, and prevents treatment-related side effects. This will also help you and your health care team focus on managing cancer-related symptoms.
Talk with your care team about whether this is a good choice for you. Clinical trials are research studies that test new treatments or learn how to use existing treatments better. Clinical studies aim to find the treatment strategies that work best for certain illnesses or groups of people. For some patients, taking part in a clinical trial may be a treatment option.
Clinical trials follow strict scientific standards. These standards protect patients and help produce reliable study results. You will be given either a standard treatment or the treatment being tested. All of the approved treatments used to treat or cure cancer began in a clinical trial.
To search for information on current or recent clinical trials for the treatment of prostate cancer, visit UrologyHealth. You and your doctor may schedule office visits for tests and follow-up over time. There are certain symptoms your doctor should know about right away, such as blood in your urine or bone pain, but it is best to ask your health care team about the symptoms you should report.
Some men find it helpful to keep a diary to help remember things to talk about during follow-up visits. Incontinence is the inability to control the release of urine and can sometimes happen with prostate cancer treatment.
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