title: Traditional approaches to androgen deprivation therapy.
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.
authors: Division of Urologic Surgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina, USA.
authors: Judd W
authors: JW
authors: Moul
authors: Christopher P
authors: CP
authors: Evans
authors: Leonard G
authors: LG
authors: Gomella
authors: Mack
authors: M
authors: Roach
authors: Robert
authors: R
authors: Dreicer
mesh_terms: D000726:Androgen Antagonists / Q000627:therapeutic use*; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D003131:Combined Modality Therapy; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000628:therapy; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000628:therapy; D013739:Testosterone / Q000037:antagonists & inhibitors; D013997:Time Factors
chemical_list: D000726:Androgen Antagonists; D018931:Antineoplastic Agents, Hormonal; D013739:Testosterone