Chemotherapy, hormone therapy and investigational medications for high risk prostate cancer.
Hormones are substances produced by glands in the body and circulated in the bloodstream. The male hormone testosterone causes the growth of prostate cancer. Hormone therapy is a cancer treatment that removes hormones or blocks their action and stops cancer cells from growing. For men with prostate cancer, hormone therapy is used to eliminate testosterone and kill the prostate cancer cells.
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Hormone therapy may be appropriate:
- As the first treatment offered for patients with metastatic prostate disease
- For some men who choose against radiation or surgery
- After radiation or surgery, for some men whose PSA continues to rise
Hormone therapy used in the treatment of prostate cancer may include the following:
- Luteinizing hormone-releasing hormone agonists can prevent the testicles from producing testosterone. Examples are leuprolide, goserelin, and buserelin.
- Antiandrogens can block the action of androgens (hormones that promote male sex characteristics). Two examples are flutamide (Eulexin), bicalutamide (Casodex), and nilutamide (Nilandron). Drugs that can prevent the adrenal glands from making androgens include ketoconazole and aminoglutethimide.
- Orchiectomy is a surgical procedure to remove one or both testicles, the main source of male hormones, to decrease hormone production.
Hot flashes, impaired sexual function, loss of desire for sex, impotence, and weakened bones may occur in men treated with hormone therapy. In addition, patients may experience fatigue, muscle loss, weight gain and anemia. It is generally recommended that men on hormone therapy take 500-1000 mg of calcium and 400 iu/day of Vitamin D in order to prevent bone loss.
The Moores UCSD Cancer Center is currently conducting several clinical research studies to evaluate different hormonal therapies and different delivery protocols. Review our database of current trials (enter prostate in the search box), and contact the Clinical Trials Staff at (858) 822-5354 or firstname.lastname@example.org to inquire about specific trials.
Chemotherapy refers to drugs that directly kill prostate cancer cells. At the UC San Diego Moores Cancer Center, you may be given the option of conventional FDA-approved drugs or the opportunity to try new investigational medications.
Docetaxel is a standard chemotherapy drug given once every three weeks. It has received FDA approval for the initial treatment of prostate cancer.
- Docetaxel combined with Prednisone - Prednisone is an oral steroid which is taken twice daily. Combining Docetaxel and Prednisone is a standard regimen for metastatic hormone resistant prostate cancer. Approximately 50-70% of patients will have a lowering of PSA with this therapy, and 20-40% of patients will have shrinkage of measurable tumors.
Patients treated with Docetaxel are at risk of developing nerve damage (neuropathy). This generally occurs only after many doses of the medications, but some patients find they need to discontinue the treatment due to the neuropathy. Others may find relief from medications that treat neuropathy.