Treatment of Prostate Cancer by Targeting the Hypothalamic-Pituitary-Gonadal Axis

[Date of Submission]

Treatment of Prostate Cancer by Targeting the Hypothalamic-Pituitary-Gonadal Axis

[Date of Submission]

Treatment of Prostate Cancer by Targeting the Hypothalamic-Pituitary-Gonadal Axis

[Date of Submission]

Treatment of Prostate Cancer by Targeting the Hypothalamic-Pituitary-Gonadal Axis

Introduction

There are two hormones inducing drugs that are used to battle the Prostate Cancer of the Hypothalamic-Pituitary-Gonadal Axis. A gonadotropin-releasing hormone agonist and a gonadotropin-releasing hormone antiagonist.

The GnRH agonist, (full form gonadotropin-releasing hormone agonist) is synthetically prepared peptide, which is created according the natural GnRH, the hypothalamic neurohormone, and this responsible for elicit a biologic response by interacting with the gonadotropin-releasing hormone receptor that is responsible for the releasing the LH and FSH in the pituary hormones.

However it has been found from studies that they induce a testosterone surge when used in men and an estrogen surge when used for females. There reason for the surge in the levels of estrogen and testosterone is that these agonists are unable to rapidly dissociate themselves from the receptor of the GnRH. Still roughly around ten days, a decrease in LH and FSH also known as profound hypogonadal effect, is obtained the downward regulation of the receptors, through the process of internalization. Commonly, this reversible and induced hypogonadism is the goal of the therapeutic treatment.

The growth of testosterone is responsible for the promoting the growth of a lot of prostate tumors. So it is often advised that the best way to tackle these tumors is by the reduction of the testosterone that is circulating in the body, to exceptionally low castration levels. This is the goal of treatment for managing advanced prostate cancer in men. In order to rapidly suppress the testosterone GnRH antagonists are used, so as to induce the suppression without surging the levels of testosterone. This phenomenon is commonly seen when patients are treated with GnRh agonists (2009, Organon).

When dealing with patients who are dealing with the advanced stages of this cancer, this testosterone surge may cause the tumor to flare up, thereby increasing the risk of precipitating a variety of clinical symptoms like ureteral obstruction, spinal cord compression and pains in the bone. This is why, drug agencies have put out warning markings with respect to this particular phenomenon when the information is being proscribed for GnRH agonists.

Since the said testosterone surge does not take place when using GnRH antagonists, patients do not require any doses of antiandrogen as a protection against the flare when there is a treatment going on for prostate cancer. These GnRh agonists are also responsible for causing a rise in the levels of testosterone levels, when they are reinjected each time into the patient's body. This particular phenomenon is also absent when using GnRh antagonists.

This why the GnRH antagonists are now the most widely preferred drugs for the treatment of the prostate cancer in both men and women.

Discussion

The full from of GnRH antagonists or the receptor blockers is Gonadotrophin-releasing hormone. They are compounds of a specific class which is similar to the structure of the GnRH which ...