Before we talk about the newest treatments, let’s take a look back at the old ones:
Chances are, you have already been on some form of Androgen Deprivation Therapy (ADT). This type of treatment removes steroids called androgens, which are related to the male hormone testosterone. And testosterone is the primary driver of prostate cancer. For some men, ADT keeps prostate cancer in check for many years. But for other men, it does not.
There are several different types of ADT, the most common of which is often called the “hormone shot”. Administered over the course of several years, injections of drugs such as Lupron and Eligard (leuprolide), Zoladex (goserelin), Trelstar (triptorelin), or Vantas (histrelin) shut down the signal from the pituitary gland that tell the testicles to make testosterone. Injections of Firmagon (dageralix) have essentially the same effect.
The testicles produce 95% of a man&8217;s testosterone. The adrenal gland produces the remaining 5%, and that can sometimes be blocked with an oral drug called Casodex (bicalutamide)
The goal of ADT in all its forms is to non-surgically reduce a man&8217;s testosterone to the level of someone who has been castrated. For some men, though, surgical castration is a better option for achieving this result.
With lowered testosterone levels come a number of possible side effects, These may include a loss of sex drive and the ability to have erections, weakened muscles and bones, fatigue, irritability, and memory lapses.
To control these side effects, stay active and get regular physical exercise. Help strengthen your bones by taking calcium supplement with Vitamin D—the typical daily dose is one Calcium 500 mg tablet with 400 IU of Vitamin D. Your doctor may check your levels and recommend a different dose. It may be slightly lower if you consume a lot of dairy.
ADT may work well for some areas of a cancer even if it doesn’t work for others. So we continue to use it indefinitely, even as we prescribe other treatments.
The choices and realities of prostate cancer are hard for any man to face. But our doctors have the compassion and deep medical knowledge to guide you through it.