In this topic, we will remain focusing on an androgen deprivation therapy in advance prostate cancer patient. I have been practicing in Cambodia for more than 5 years. I was founding that the prostate cancer patients more likely getting higher rate in each year and more common for both local and foreigners, they have tried to seek for a good quality service with an up-to-date management in prostate cancer treatment.
First of all, you must know that the male hormone- testosterone plays a major role in prostate cancer aggressiveness activity; therefore, we try in every way to suppress this hormone. In the past, in order to do androgen deprivation therapy, there was only one way; a testicular-removal-surgery. This kind of operation could be able to suppress testosterone dramatically because we have removed testosterone factory-like organ from patient’s body. Meanwhile, a confirmed reports actually proved that the testicular-removed patient could be possible confront the psychological trauma from being out of a balls which is the remarkable symbolic of human being.
Currently, the modern and mercy way for doing androgen deprivation therapy has been invented. The preparation can be either subcutaneous or intramuscular injection form which varies from 1 month – 1 year injection interval. There’s a little concern on not being completely 100% testosterone therapeutic level control which need to do serum testosterone measurement regularly. Here are the examples in the market.
Examples of Medical Androgen deprivation therapy
- Generic name: Leuprolide
- 95% – 98.8% of completely testosterone suppression is reported (Consider as < 50 ng/dl cut-off point)
- Generic name: Geserelin
- 96% of completely testosterone suppression is reported (Consider as < 20 ng/dl cut-off point)
Normally, my current practicing is 3-month interval of intramuscular injection shots with a regular checkup as following tests
- Prostate specific antigen
- I am using PSA Doubling time for checking the prostate cancer activity
- Testosterone level
- Checking on how well the injection can be suppressed and circulating testosterone level in serum
- I am using < 50 ng/dl as cut-off point reference from National Comprehensive Cancer Network (NCCN) guideline 2021on prostate cancer
The current practicing in prostate cancer is keeping update every 3 months. It is a duty of Uro-Oncologist to stay tune in this. Actually, this is just a little small aspect in prostate cancer management, and you better discuss with an up-to-date Uro-Oncologist how to do tailor-made androgen deprivation therapy. See you in next article!