It may be hard to learn that you or your loved one has advanced prostate cancer. Understanding your diagnosis and the treatment options available to you is an important first step.
When you were diagnosed with advanced prostate cancer, your doctor may have said it was recurrent, locally advanced, or metastatic. These are types of advanced prostate cancer, defined as follows:
When prostate cancer has returned—following initial treatment such as radiation therapy or surgery—as detected by a rising PSA* level or positive biopsy/scan
When prostate cancer has spread to tissues near the prostate
When prostate cancer has spread far from the prostate to other parts of the body, such as the lymph nodes, bones, liver, or lungs
*PSA stands for prostate-specific antigen.
Testosterone is the male hormone that can cause prostate cancer to grow and spread. That’s why advanced prostate cancer is often treated with hormone therapy, which helps lower the amount of testosterone the body makes. Your doctor may talk about a type of hormone therapy called ADT, or androgen deprivation therapy. Understand that ADTs have benefits and risks, so ask your doctor how they may affect you.
There are 2 types of ADT medications—LHRH agonists and GnRH antagonists. LHRH agonists include injection treatments like Lupron Depot® (leuprolide acetate for depot suspension) and Eligard® (leuprolide acetate for injectable suspension). GnRH antagonists include injection treatment Firmagon® (degarelix for injection) and the pill ORGOVYX.
Lupron Depot is a registered trademark of AbbVie Inc. Eligard is a registered trademark of the Tolmar group. Firmagon is a registered trademark of Ferring B.V.
The 2 types of ADT medications work in different ways to lower testosterone
LHRH agonists work by initially activating certain hormone receptors
At the onset of therapy, LHRH agonists* activate certain hormone receptors—increasing testosterone levels before lowering them. This temporary surge in testosterone levels is known as a “testosterone flare.” The testosterone flare may worsen certain symptoms in some patients and require additional medicine to manage its effects.
*LHRH stands for luteinizing hormone–releasing hormone.
GnRH antagonists work by directly inhibiting certain hormone receptors
By directly inhibiting (or blocking) certain hormone receptors, GnRH antagonists† lower testosterone levels. This results in a decrease in testosterone levels without causing a testosterone flare.
†GnRH stands for gonadotropin-releasing hormone.
How GnRH antagonists and LHRH agonists affect testosterone
LHRH agonists cause testosterone levels to initially increase before they decrease. GnRH antagonists lower testosterone levels without causing a flare.