LH-RH analogue treatment in prostate cancer for 25 years
Since a quarter century, the treatment with so-called LH-RH analogues is available.The experiences and successes thus summarizes a just published professional articles.
because prostate cancer is so common, great efforts are being made to improve the diagnosis and therapy. For more than 60 years it is known that this form of cancer by androgens, the male sex hormone dependent. limits of surgical castration and estrogen treatment First, they tried to reduce the androgen formation by removal of the testicles (castration) or the androgen effect by high doses of estrogens to block the female sex hormones (medical castration against sex hormone treatment). , the high response rates of 60-70% showed that prostate cancer is sensitive to hormonal treatment. It is even the most sensitive of all hormone-sensitive cancers. However, both methods are now used because of the mental and physical side effects, only in special cases. The first LH-RH analogue treatment after years of animal experimentation, the first prostate cancer patient has been treated with an LH-RH analogue in 1979. After an initial increase the androgen levels fell off after two weeks of unexpectedly strong, as far as after surgical castration. But only since 1983 is known about how these androgen-lowering works (see "Drug treatment of prostate cancer"). Since then, other LH-RH analogues have been developed and tested in numerous studies to optimize the dosage and the feed path. meantime were treated millions of men, and there were no adverse effects, except those of the (intended) androgen reduction. LH-RH analogues in the localized prostate cancer , the application of LH-RH analogues has expanded because of this good tolerability: After the progress that they had brought in the treatment of metastatic prostate cancer, they could also be used in the localized prostate cancer. doing so, they reduce more recent studies have shown that the death rate after 5 years to 37-81% (depends on stage, Gleason score and initial treatment). Also to the primary use of LH-RH analogues (without initial treatment such as radical prostatectomy) are promising first results before. Complete androgen blockade as a complete androgen blockade is the treatment of a combination of LH-RH analogue and antiandrogen. In advanced prostate cancer have the following advantages over the surgical castration identified: Higher response of the tumors, better relief of metastatic pain, prolonged cancer-free survival, longer survival time. During localized prostate cancer has been shown that post-treatment by means of complete androgen blockade the tumor not only prevented from growing, but even brings him in long term treatment to disappear. After 6 years, the probability of a permanent cure 50% after 8-10 years 90%. And as long as there are no metastases, the tumor is rarely resistant, even after interruption of continuous therapy. This argues for an early complete androgen blockade for at least 6 years in patients with localized prostate cancer, in which the initial treatment was not successful and other secondary treatments are not promising. Due to the long duration until disappearance of the tumor should be a PSA Waste not lead to the premature termination of therapy. Insofar intermittent (repeatedly interrupted) androgen blockade is currently outside of clinical trials is not recommended. too, still a lack of studies directly comparing with LH-RH analogues without antiandrogen for use as first-line treatment. But despite all the new findings: When it comes down to prostate cancer as early as possible to recognize and effectively treat even in the localized stage immediately because a metastasis makes treatment difficult immensely and makes a cure for the exception.. Source: Labrie, F.: Medical castration with LHRH agonists: 25 years later with major benefits Achieved on survival rate in prostate cancer Journal of Andrology 3 (2004) 305-313.
because prostate cancer is so common, great efforts are being made to improve the diagnosis and therapy. For more than 60 years it is known that this form of cancer by androgens, the male sex hormone dependent. limits of surgical castration and estrogen treatment First, they tried to reduce the androgen formation by removal of the testicles (castration) or the androgen effect by high doses of estrogens to block the female sex hormones (medical castration against sex hormone treatment). , the high response rates of 60-70% showed that prostate cancer is sensitive to hormonal treatment. It is even the most sensitive of all hormone-sensitive cancers. However, both methods are now used because of the mental and physical side effects, only in special cases. The first LH-RH analogue treatment after years of animal experimentation, the first prostate cancer patient has been treated with an LH-RH analogue in 1979. After an initial increase the androgen levels fell off after two weeks of unexpectedly strong, as far as after surgical castration. But only since 1983 is known about how these androgen-lowering works (see "Drug treatment of prostate cancer"). Since then, other LH-RH analogues have been developed and tested in numerous studies to optimize the dosage and the feed path. meantime were treated millions of men, and there were no adverse effects, except those of the (intended) androgen reduction. LH-RH analogues in the localized prostate cancer , the application of LH-RH analogues has expanded because of this good tolerability: After the progress that they had brought in the treatment of metastatic prostate cancer, they could also be used in the localized prostate cancer. doing so, they reduce more recent studies have shown that the death rate after 5 years to 37-81% (depends on stage, Gleason score and initial treatment). Also to the primary use of LH-RH analogues (without initial treatment such as radical prostatectomy) are promising first results before. Complete androgen blockade as a complete androgen blockade is the treatment of a combination of LH-RH analogue and antiandrogen. In advanced prostate cancer have the following advantages over the surgical castration identified: Higher response of the tumors, better relief of metastatic pain, prolonged cancer-free survival, longer survival time. During localized prostate cancer has been shown that post-treatment by means of complete androgen blockade the tumor not only prevented from growing, but even brings him in long term treatment to disappear. After 6 years, the probability of a permanent cure 50% after 8-10 years 90%. And as long as there are no metastases, the tumor is rarely resistant, even after interruption of continuous therapy. This argues for an early complete androgen blockade for at least 6 years in patients with localized prostate cancer, in which the initial treatment was not successful and other secondary treatments are not promising. Due to the long duration until disappearance of the tumor should be a PSA Waste not lead to the premature termination of therapy. Insofar intermittent (repeatedly interrupted) androgen blockade is currently outside of clinical trials is not recommended. too, still a lack of studies directly comparing with LH-RH analogues without antiandrogen for use as first-line treatment. But despite all the new findings: When it comes down to prostate cancer as early as possible to recognize and effectively treat even in the localized stage immediately because a metastasis makes treatment difficult immensely and makes a cure for the exception.. Source: Labrie, F.: Medical castration with LHRH agonists: 25 years later with major benefits Achieved on survival rate in prostate cancer Journal of Andrology 3 (2004) 305-313.
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