Prostate cancer is the most sensitive cancer to hormones.  It is therefore very important to take benefit of this exclusive property and to constantly use most advantageous androgen blockades when hormone therapy is the suitable action.  A basic examination is that the serum testosterone concentration only reproduce the amount of testosterone of testicular origin which is free in the blood from which it arrives at all tissues. Latest data illustrates, on the other hand, that more or less the same quantity of testosterone is made from dehydroepeandrosterone (DHEA) straight in the tangential tissues, simultaneously with the prostate, and does not become detectable in the blood.  Accordingly, after castration, the 95-97% fall in serum testosterone does not reflect the 40-50% testosterone (testo) and dihydrotestosterone (DHT) made locally in the prostate from DHEA of adrenal  origin.  Actually, though removal  of testicular androgens by castration alone has not at all been exposed to extend life in metastatic prostate cancer, mixtures of castration(surgical or medical with a gonadotropin-releasing hormone (GnRH) agonist) with a chaste anti-androgen has been the first treatment exposed to make longer life.  Most significant, when applied at the limited to a small area, the same combined androgen blockade (CAB) can supply long-term control or cure of the disease in more than 90% of cases.

Apparently, because prostate cancer frequently develops and metastasizes without signs or symptoms, screening with prostate-specific antigen (PSA) is very important to identify prostate cancer at an early period before metastasis takes place and the cancer turns into a non-curable state.  Whereas the function of androgens was supposed to have turn out to be non-significant in cancer making progress under any form of androgen blockade, latest data have revealed improved appearance of the androgen receptor (AR) in treatment-resistant disease with an  advantage of additional androgen blockade.  Because the existing anti-androgens have small affinity for AR and cannot block androgen action totally, particularly in the existence of bigger AR levels, it develops into essential to find out more powerful and merely antagonistic blockers of AR.  The information gotten from compounds under progress are promising.  At the same time, waiting for these new anti-androgens combined treatment with castration and a pure anti-androgen (bicalutamide, flutamide or nilutamide) is the merely accessible and the greatest systematically based means of treating prostate cancer by hormone therapy at some phase of the disease with the optima possibility of victory and yet heal in localized disease.

Tags | combined androgen blockade, DHEA, prostate-specific antigen, Treating Prostate Cancer