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How are luteinizing hormone-releasing hormone analogs used to treat prostate cancer?

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Most patients who receive hormonal therapy choose luteinizing hormone-releasing hormone (LHRH) analogs. These drugs work by decreasing testosterone production to very low levels by depleting the pituitary gland of the hormone needed to produce testosterone. However, before this decrease in testosterone occurs, patients experience a brief and temporary increase in testosterone production and tumor growth. This is because of a transient increase in release of LHRH from the pituitary gland with a resulting stimulation of testosterone production. This phenomenon, called tumor flare, can cause increased symptoms from the prostate cancer that didn't exist before the patient received the therapy. Some doctors prescribe antiandrogens to combat the symptoms caused by tumor flare. LHRH analogs are administered via injection or small implants placed under the skin. The most commonly used LHRH analogs in the U.S. are leuprolide (Eligard, Lupron), histrelin (Vantas), triptorelin (Trelstar), and goserelin (Zoladex). These drugs carry a risk of triggering diabetes, heart disease, osteoporosis, and/or stroke. Before starting one of these drugs, patients should tell their doctor if they have a history of diabetes, heart disease, stroke, heart attack, high blood pressure, high cholesterol, or cigarette smoking.

SOURCES: 

American Cancer Society. 

National Cancer Institute. 

Cancer Research UK.  

News release, Astellas Pharma Inc.

UpToDate.

Reviewed by Jennifer Robinson on July 24, 2018

SOURCES: 

American Cancer Society. 

National Cancer Institute. 

Cancer Research UK.  

News release, Astellas Pharma Inc.

UpToDate.

Reviewed by Jennifer Robinson on July 24, 2018

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How are luteinizing hormone-releasing hormone antagonists used to treat prostate cancer?

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