| Prostate cancers
have never been observed in eunuchs. This suggest that androgens
play an important role in the pathogenesis of prostate cancers.
Therefore it was logical to try androgen withdrawal as a
therapeutic principle in the treatment of prostate cancer. Indeed
orchidectomy was performed by the urologists at the end of the
last century but for unknown reasons this form of therapy was
forgotten.
The rationale for androgens withdrawal was
re-established by Huggins in the 1940's. On average, 70% of the
patients show improvement. Currently there are two
principally different modalities for depriving the tumour cells of
androgens. The first is mainly a reduction in the endogenous
androgen concentration and the second involves the inhibition of
the action of androgens.
The methods of androgen deprivation
include orchidectomy, oestrogen treatment, pure anti-androgens,
anti-androgens of the cyproterone acetate type, LHRH agonists,
progesterone treatment, inhibitors of steroid biosynthesis
The role of chemotherapy remains
controversial. Mitoxantrone, Navelbine, and docetaxel are used in
some cases. Radiotherapy is used to treat painful bone metastasis.
Newer therapeutic options such as intravenous isotope strontium 89
and samarium 153 have been found to have symptomatic benefit for
painful widespread metastasis.
Metastatic prostate cancer is generally a
slowly progressive tumour that will respond to hormonal therapy
for some years. Aggressive treatment programs should be avoided
and chemotherapy has limited application.
If you have questions related to this article you may e-mail me
at doctor@soontongkiong.com quoting the contents of the article.
About the author
DR SOON is a medical practitioner. He holds four degrees. MBBS
(University of Malaya), MBA (University of East Asia), LLB (Hons)
(University of Wolverhampton), Master of Medicine (Edith Cowan
University
:
Dr SOON is the owner of AskMyVisitor.com and MyScriptDoctor.com
where you can find the most up-to-date advice and information
on
many medical, health and lifestyle topics.
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