Rigi10™ Malleable Penile Prosthesis
Also Known As
Hormone therapy for prostate cancer, Androgen suppression therapy, Medical castration, Surgical castration (if orchiectomy), Combined androgen blockade (CAB) (when used with antiandrogens)
Definition
Androgen Deprivation Therapy (ADT) is a cornerstone treatment for prostate cancer, particularly in advanced stages. It functions by reducing the levels of androgens (male hormones like testosterone) in the body or by preventing these hormones from reaching cancer cells.¹ Androgens fuel the growth of prostate cancer cells; therefore, lowering their levels or blocking their action can slow down tumor growth, shrink tumors, and alleviate symptoms.¹ ADT can be achieved through surgical means (orchiectomy, removal of testicles) or, more commonly, through medications such as LHRH (luteinizing hormone-releasing hormone) agonists, LHRH antagonists, or antiandrogens.¹ LHRH agonists and antagonists work by disrupting the signaling pathway that leads to testosterone production in the testicles, effectively achieving medical castration.¹ Antiandrogens, on the other hand, block androgen receptors on cancer cells, preventing testosterone from binding and exerting its growth-promoting effects.¹ Some newer agents, known as androgen synthesis inhibitors, can block androgen production throughout the body, including from the adrenal glands and the cancer cells themselves.¹
Clinical Context
ADT is employed in various clinical scenarios for prostate cancer management.¹ It is a standard of care for metastatic prostate cancer, where the disease has spread to other parts of the body.¹ It is also used for locally advanced prostate cancer, often in conjunction with radiation therapy, to improve treatment efficacy.¹ In men with recurrent prostate cancer after initial treatments like surgery or radiation, ADT can be used to control the disease, especially if the recurrence is symptomatic or if there is evidence of rising PSA (prostate-specific antigen) levels indicating disease progression.¹ Patient selection for ADT considers factors such as the stage and grade of the cancer, the patient’s overall health, potential side effects, and patient preferences.¹ Expected outcomes include a reduction in PSA levels, shrinkage of tumors, alleviation of cancer-related symptoms (like bone pain), and, in many cases, an extension of survival.¹ However, ADT is associated with a range of side effects, including hot flashes, loss of libido, erectile dysfunction, fatigue, and potential long-term effects like bone density loss and metabolic changes, which need to be managed.¹