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Page 346
Hormone Therapy
A standard form of therapy to treat prostate cancer that has gone beyond the prostate gland, hormone therapy is used to inhibit the production of the male hormone, testosterone, thereby inhibiting the growth of the cancer as well. Hormonal drugs currently in use include:
Lupron (Zoladex in oral form). A leutinizing hormone-releasing antagonist that lowers the amount of testosterone available.
Flutamine. An agent that blocks the action of androgen hormones, such as testosterone.
Estrogens (such as DES). Agents that inhibit the binding of testosterone to a cell's hormone receptors.
Common side effects of hormone therapy include mild diarrhea, breast tenderness and enlargement, diminished sex drive, hot flashes, and diminished muscle tone.
Hormone therapy is usually suggested as a primary therapy for older men or for men who have relapsed after surgery or radiation therapy. The potential disadvantage of hormone therapy is that resistant cells may develop and grow more rapidly, causing a more aggressive disease pattern.
Another method used to lower testosterone production is a procedure called bilateral orchiectomy, or surgical removal of the testicles. This is a palliative rather than curative treatment, usually recommended for those with late-stage prostate cancer (Stages C or D). In many cases, the benefits of orchiectomy are temporary, and the cancer reappears. For this reason, an androgen blocker, such as flutamine, is normally recommended to help minimize this risk. The side effects of orchiectomy are similar to those of hormone therapy listed above.
Chemotherapy
Although chemotherapy is sometimes used in advanced stages of prostate cancer, it has not been found to be very effective in treating this disease. Chemotherapeutic agents commonly used include vinblastine, etoposide, mitoxantrone, and taxol. 21

 
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