HORMONE THERAPY FOR ADVANCED PROSTATE CANCER
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The growth of prostate cancer cells is driven by androgens in the body. Androgens are male sex hormones such as testosterone. Lowering these hormones can help slow the growth of the cancer. Initial hormone treatment as described in chapter 12 can work for months or years, but over time, the cancer cells may start to change and adapt. This is analogous to bugs, who over time, start to develop resistance to certain antibiotics. Similarly, the prostate cancer cells start to grow despite low levels of testosterone and the initial hormones stop being so effective. At this stage, other hormone treatments may work. The aim of second-line hormone treatments is to control the cancer, delay the onset of any symptoms, manage any symptoms, and prolong overall survival. It is usual to continue with the first-line hormone treatment that you are on, such as your injections. Drugs to lower androgen production: ABIRATERONE (Zytiga®) Common Questions
Most androgens are made by the testicles, but a small proportion is also made by the 1. Can I live without my prostate? adrenal glands. Whilst LHRH agonists and antagonists the testicular production Yes, a manstop can live without his prostate. of androgens, they do not affect the androgensThe made the adrenal glands,foror by wholeby prostate may be removed cancer partcancer. of it when it is enlarged and the prostate cancer cells themselves, which can feedorthe causing symptoms.
Abiraterone is an androgen synthesis inhibitor2.and works by blocking an enzyme What conditions other than cancer called CYP17. This enzyme is found in testicular, adrenal, some prostate can affect and the prostate? • B enign (non-cancerous) cancer cells and is needed to convert cholesterol to testosterone. Itenlargement is a type of called BPH hormone therapy. When is abiraterone used?
• Prostatitis - infection or inflammation of the prostate.
3. Do biological women have a prostate?
No. stopped responding to first-line • In men with advanced prostate cancer that has hormone treatments 4. How big can the prostate get? There is no real upper limit.
• In men with advanced prostate cancer that is• high risk (such as high Gleason score) A small sized prostate has a volume of 30-40ml • In men with advanced cancer with no symptoms or only mild symptoms after • A medium sized prostate has a volume first-line hormone treatments of 40-80ml
• A large sized prostatecancer has a volume • Before or after chemotherapy in men with advanced prostate greater than 80ml.
• Abiraterone is preferable over enzalutamide if there is a history of fits or extreme tiredness FIGHTING PROSTATE CANCER - A SURVIVAL GUIDE
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