Thyme Endocrine therapy for prostate cancer is a therapy that suppresses androgen levels with drugs or surgery to delay tumor progression. It mainly includes gonadotropin-releasing hormone analogues, anti-androgen drugs, orchiectomy, etc.
Gonadotropin-releasing hormone analogs indirectly reduce testicular secretion of testosterone by inhibiting the release of luteinizing hormone from the pituitary gland. These drugs require monthly or quarterly subcutaneous injections and may cause side effects such as hot flashes and osteoporosis. Patients need to regularly check testosterone levels and bone density during medication. Commonly used drugs include leuprolide acetate sustained-release microspheres, goserelin acetate sustained-release implants, etc.
Antiandrogens directly block the binding of androgens to receptors and can be divided into steroidal and nonsteroidal drugs. Nonsteroidal drugs such as bicalutamide selectively inhibit androgen receptors and are often used in combination with gonadotropin-releasing hormone analogues. Breast swelling and pain and abnormal liver function may occur during medication, and liver ultrasound and transaminases need to be reviewed regularly.
Orchiectomy is a permanent castration treatment, and testosterone can be reduced to castration levels within 48 hours after surgery. The surgery is minimally invasive but may cause psychological disorders, and the patient's mental state needs to be fully assessed before surgery. After surgery, you need to pay attention to cardiovascular health and supplement calcium to prevent osteoporosis.
New endocrine therapy drugs such as abiraterone tablets block extratesticular androgen synthesis by inhibiting the CYP17 enzyme and are suitable for castration-resistant prostate cancer. It needs to be taken in combination with prednisone tablets. Common adverse reactions include hypertension and hypokalemia. Enzalutamide soft capsules block androgen receptor signaling, which may cause fatigue and risk of seizures.
During endocrine treatment, it is necessary to maintain a low-fat and high-fiber diet, supplement with appropriate amounts of vitamin D and calcium, and perform 150 minutes of moderate-intensity exercise every week. Regularly review prostate-specific antigen, testosterone and imaging. If you have bone pain or difficulty urinating, you should seek medical treatment promptly. Psychological support can help improve treatment compliance, and family members should pay attention to the patient's emotional changes.
