How is prostate cancer treated?
When Prostate Cancer are primarily a glandular cancer, starting from the outer cells of the glands shares. The emergence causes of prostate cancer are largely unknown. The time of diagnosis of prostate cancer or the present stage decides on further therapy concepts.
Operation in prostate cancer
The organ-limited tumor can be cured by radical prostatectomy. In the early tumor stage of prostate cancer can be the local radiation therapy, brachytherapy, an alternative to radical prostatectomy.
Occur in prostate cancer bladder emptying disorders - the symptoms are the same as those of benign prostatic hyperplasia - can be improved by a electroresection urine flow. However Electroresection of the prostate during prostate cancer has only the removal of bladder outlet obstruction to the target and not a cure.
Conservative treatment
The treatment with female hormones was since the investigations of Huggins (1941) in addition to the surgical removal of the testicle tissue is generally the treatment of choice. Huggins was awarded in 1956 for the discovery that the growth of prostate cancer is hormone dependent, the Nobel Prize. The treatment is based on the observation that eunuchs never a prostate cancer was found and the prostate gland regresses after castration and taking female hormones.
The hormone-lowering therapy is the cornerstone of treatment for advanced prostate cancer.Male hormones are considered to be promoting for a prostate cancer
Almost all medicinal measures have a castration effect result.
For over 40 years were the opposite sex treatment (estrogen treatment) and orchiectomy the treatment of choice for metastatic prostate carcinoma. Treatment with estrogens is due to side effects - now abandoned - gynecomastia, tendency to edema and cardiovascular complications. Orchiectomy is still the treatment of prostate cancer with safe lowering of testosterone to castrate levels (10% of the original value). As better alternatives to orchiectomy are now the LHRH analogues that lead to drug-induced castration or the use of anti-androgens. Anti-androgens block the male hormones such that the growth of malignant prostate cells is braked. The side effects are observed. medication The most recognized method of Androgenabsenkung has become the treatment with LHRH agonists. , the naturally occurring luteinizing hormone-releasing hormone (LHRH) stimulates the release of the gonadotropins, luteinizing hormone and follicle stimulating hormone from the anterior pituitary.The result is a release of testosterone from the Leydig cells of the testes. Under physiological conditions, the luteinizing hormone releasing hormone is released in the form of waves, which are necessary for its activity. The chronic use of potent analogs leads to a depletion of luteinizing hormone from the pituitary gland, followed by a weakening of the receptors for luteinizing hormone-releasing hormone followed. As a result, the pituitary is refractory and resistant to further stimulation. The subsequent Gonadotropinunterdrückung and reduction of serum testosterone concentrations are the justification for the use of luteinizing hormone-releasing hormone analogues in patients with prostate cancer.
The drugs are injected as a month or three-month deposits under the skin. All LHRH agonists have approximately the same active qualities. The success of treatment is comparable to castration. The androgen, however, is reversible. Each hormone treatment started to be consistently continued to the end of life, intermittent treatment is currently being tested. Side effects are hot flashes and psychological problems of the patients with loss of libido.
Another additional treatment with so-called anti-androgens is recommended at the start of therapy. Antiandrogens, in combination with an LHRH agonist or surgical castration for a complete androgen blockade in patients with advanced prostate cancer. A sole therapy with antiandrogens should not be performed. (02/2004)
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