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This procedure involves surgical removal of the
testicles. This removes the main source of male
hormones and by reducing the level of androgens temporarily
prevents the growth of most cancers. This procedure may
be done under local anaesthetic on an out-patient basis.
Luteinizing hormone-releasing hormone analogues block
the signals from the brain that tell the testicles to produce
testosterone. Research shows that these drugs may
lower the level of testosterone as effectively as surgical
removal of the testicles. LH-RH analogues are given by injection
either monthly or every 3 months. The 2 LH-RH analogues
currently used are Lupron (leuprolide) and Zoladex (goserelin).
Antiandrogens are taken in a pill form, usually in combination
with LH-RH analogues. Antiandrogens block a form of testosterone
from reaching the prostate. They block
the small amount of androgens produced by the adrenal glands, and are used in combination with one of the other two therapies to form a complete androgen blockade (CAB).
Combination Therapy: several trials have suggested
that the combination of a LH RH analogue and an antiandrogen
or orchiectomy and an antiandrogen are more effective than
an LHRH analogue or orchiectomy alone. Many clinicians believe
that combination therapy is the treatment of choice for
men with prostate cancer that has spread. Some other clinicians
believe that this combination therapy has little if any
benefit over more standard methods. Consult your physician
for more information.
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Hormone therapy is used primarily when initial forms of
therapy such as radical prostatectomy or radiation have
failed. It may also be used when a patient is either unable
or unwilling to undergo surgery or radiation. Occasionally
hormone therapy may be used in combination with another
therapy such as radiation.
Hormone therapy is felt to slow the growth of prostate
cancer but is not considered to be curative. This treatment
provides excellent pain control from advanced cancer. However,
the duration of its effectiveness varies from individual
to individual. Some men experience relief for greater than
10 years while others may have relief for less than one
year.
The degree to which men experience side effects from hormone
therapy varies greatly. Side effects may include sweating,
hot flashes, decreased sexual desire and function, as well
as breast swelling and tendernous.
Other side effects include anemia, a decrease in muscle
and bone strength and a risk of fractures in the long bones
of the body.
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