Endocrine Therapy For Prostate Cancer

Endocrine therapy for prostate cancer

A problem in the endocrine therapy is hormone insensitivity to relatively frequently adjusts in primary hormone-sensitive prostate carcinoma. What are the options to extend the effectiveness of endocrine therapy , and what options exist if the hormone insensitivity has already occurred ?

When a hormone insensitivity occurred , but the hormone ablation using LH -RH analogue therapy must be maintained, because it is only way to ensure that the hormone-dependent cell clones of the tumor could continue to be recognized under constant control of testosterone levels. In patients with complete androgen blockade , at least tentatively at first the antiandrogen withdrawal syndrome can be exploited. The issuing of the Antiadrogens a drop in PSA levels is achieved by 50 % to approximately 25 % of cases. This effect lasts between three and six months.

In the further course of the combination of estrogen and nitrogen load in the form of Estrramustin - phosphate can then be used . It is conceivable, moreover , to increase the effectiveness of this substance by cytostatic agents such as taxanes and etoposide . As a parameter for the effectiveness of this therapy is a PSA decline of more than 50 %.

In this stage of the disease is symptomatic therapy by nature in the foreground. It aims at the elimination of pain and preservation of quality of life. Accordingly, the nuclear medicine administration of yttrium or rhenium , treatment with prednisone and above all to the medikamtentöse pain management including the bisphosphonates in this situation is to percutaneous pain irradiating to think.