Traditional approaches to androgen deprivation therapy

Judd W. Moul, Christopher P Evans, Leonard G. Gomella, MacK Roach, Robert Dreicer

Research output: Contribution to journalArticle

6 Scopus citations

Abstract

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.

Original languageEnglish (US)
JournalUrology
Volume78
Issue number5 SUPPL.
DOIs
StatePublished - Nov 2011

ASJC Scopus subject areas

  • Urology

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    Moul, J. W., Evans, C. P., Gomella, L. G., Roach, M., & Dreicer, R. (2011). Traditional approaches to androgen deprivation therapy. Urology, 78(5 SUPPL.). https://doi.org/10.1016/j.urology.2011.05.051