Irradiation | Therapy prostate cancer

Irradiation

Radiotherapy for prostate cancer can be sensibly carried out at all localized stages of the disease. Using modern techniques, high radiation doses can be achieved in the tumor region today. Thus, an equivalent cure rate and disease prognosis can be achieved as with prostatectomy. Erectile dysfunction and urinary incontinence are also typical side effects here, but occur less frequently and less pronouncedly than after a prostatectomy. In addition, reactive inflammation of the mucous membranes of the bladder and rectum can occur.

Hormone therapy (antiandrogen therapy)

It has been proven that the prostate needs certain hormones for its function. When these substances are withdrawn, not only does the gland itself shrink, but also any tumor that may be present. Conversely, the administration of male hormones (testosterone) leads to a growth spurt.

It should therefore never be administered to treat potency disorders in cases of existing prostate cancer. Hormone therapy is used in cases of proven lymph node or distant metastases and, depending on the aggressiveness of the tumor cells, also as an adjunct before or after surgery or radiotherapy. Methods: Usually the effect of the antiandrogenic treatment diminishes after 2 – 3 years.

A complete hormone blockade should now be performed by combining antiandrogen and GnRH inhibitors. If this is not feasible, the addition of chemotherapeutic agents may be considered. 60 % of patients respond initially, but in the long run an objective improvement is rare.

One should think intensively about whether the hoped-for benefit is worth the expected side effects. Here you can find out everything about the topic: Hormone preparations

• Orchiectomy: removal of the hormone-producing testicular tissue. The capsule and the epididymis are left in place.

  The testosterone level is reduced to 10% of the initial level.The treatment is inexpensive and does not require ongoing follow-up examinations.

• GnRH – Analogues: These are artificial hormones that intervene in the control circuit and lead to a drop in testosterone levels by constantly blocking receptors. The effect is equivalent to orchiectomy. Initially, however, there is a testosterone increase (flare-up phenomenon), which can be counteracted with antiandrogens in the first 3 weeks of therapy.
• Oestrogens: They act by inhibiting the higher-level hormones in the pituitary gland.

  However, there is a risk of cardiovascular problems. For this reason, long-term therapy is rarely used. However, there is the possibility of treating advanced stages with a combination of estrogen and a cytostatic (cell growth inhibitor).

• Antiandrogens: Cyproterone acetate: This drug inhibits testosterone production and action simultaneously.

  It may cause impotence, gynecomastia (breast growth) and gastrointestinal problems. Non-steroidal antiandrogens (flutamide, etc. ): They inhibit the uptake of testosterone and its active forms into the cell by preventing it from binding to its receptors.

  This means that they do not interfere with the formation of testosterone. The blood level remains constant for a while, so that potency is still somewhat preserved.

• Cyproterone acetate: This drug inhibits testosterone production and action simultaneously. It may cause impotence, gynecomastia (breast growth) and gastrointestinal problems.
• Non-steroidal antiandrogens (flutamide, etc.

  ): These inhibit the uptake of testosterone and its active forms into the cell by preventing it from binding to its receptors. This means that they do not interfere with the formation of testosterone. The blood level remains constant for a while, so that potency is still somewhat preserved.

• Cyproterone acetate: This drug inhibits testosterone production and action simultaneously.

  It may cause impotence, gynecomastia (breast growth) and gastrointestinal problems.

• Non-steroidal antiandrogens (flutamide, etc. ): These inhibit the uptake of testosterone and its active forms into the cell by preventing it from binding to its receptors. This means that they do not interfere with the formation of testosterone. The blood level remains constant for a while, so that potency is still somewhat preserved.