Traditional approaches to androgen deprivation therapy.

Published

Journal Article

For most of the past 25 years, 1 of the favored approaches to treating prostate cancer has been the suppression of circulating testosterone with luteinizing hormone-releasing hormone (LHRH) agonists. LHRH agonists produce a downregulation of LHRH receptors and an uncoupling of the LHRH signal transduction mechanism. This leads to a marked reduction in the secretion of bioactive hormones stimulating testosterone production and eventual induction of a reversible, but transient and incomplete, state known as "selective medical hypophysectomy." The treatment with LHRH agonists has proved effective in many settings; however, the dosage and timing strategies depend critically on the patient's disease risk and progression. More recent investigations have suggested that a newer, quicker acting, pure gonadotropin-releasing hormone antagonist might be a preferable treatment approach. It remains a fundamental truth, however, that hormonal therapy is both overused and more toxic than generally appreciated. Therefore, a complete understanding of the indications and applications of this approach is essential for the practice of evidence-based medicine.

Full Text

Duke Authors

Cited Authors

  • Moul, JW; Evans, CP; Gomella, LG; Roach, M; Dreicer, R

Published Date

  • November 2011

Published In

Volume / Issue

  • 78 / 5 Suppl

Start / End Page

  • S485 - S493

PubMed ID

  • 22054920

Pubmed Central ID

  • 22054920

Electronic International Standard Serial Number (EISSN)

  • 1527-9995

Digital Object Identifier (DOI)

  • 10.1016/j.urology.2011.05.051

Language

  • eng

Conference Location

  • United States