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Prostate Cancer Questions and Answers With Dr. Manyak
Dr. Manyak, MD, is a board-certified specialist in urology. Here, he answers your
questions about prostate cancer treatment, side effects and ELIGARD.
LHRH (luteinizing hormone-releasing hormone) agonists are frequently used hormonal
therapies. These drugs were developed to offer patients a nonsurgical alternative
to removal of the testicles. LHRH agonists are similar to a naturally occurring
hormone in the body that normally stimulates the production of testosterone. Changing
the pattern of LHRH release reduces the hormone production.
Most LHRH (luteinizing hormone-releasing hormone) agonists differ in how they are
given to the patient.
For instance, the administration of the drug and needle size vary
with each product. The volume (or amount) of the drug that gets injected
differs from product to product and may affect how the injection feels. The method
of the administration varies with each product, too. Some of the drugs are injected
once every 1, 3, 4 or 6 months, and others are surgically implanted annually.
Yes, injections of LHRH agonists stimulate a short surge of testosterone for about
2 weeks. The body reads this as being too much testosterone and essentially shuts
down the hormone production. As a result, testosterone levels fall.
ELIGARD is an LHRH (luteinizing hormone-releasing hormone) agonist. It contains
leuprolide acetate, a widely prescribed hormonal therapy for the palliative treatment
(management of symptoms) of advanced prostate cancer. Leuprolide acetate limits
the signal that tells the testicles to produce testosterone.
ELIGARD is injected just under the skin with a short needle. The injection is called
subcutaneous because it goes under the skin rather than directly into the muscle,
which is called intramuscular.
In clinical studies, patients on ELIGARD experienced reduced testosterone levels
and reduced serum prostate-specific antigen (PSA) levels for those that started
with elevated PSA levels. ELIGARD is available in 1, 3, 4 and 6-month formulations
giving you the option that may be right for you. ELIGARD is administered under the
skin with a small needle as a liquid and once solidified releases medication uniformly
throughout the treatment period.
Testosterone is responsible for much of the male sex drive, called libido. Testosterone
also plays an important role in the ability to get an erection. When testosterone
is eliminated from the body, it is common for men to lose their sex drive and their
ability to achieve or maintain an erection. However, this doesn't happen to everyone.
It's not really understood how reducing testosterone brings on hot flashes. However,
it's true that hot flashes are a common side effect of ELIGARD therapy. Hot flashes
can range from annoying to debilitating. Sometimes hot flashes are associated with
facial flushing, redness, and increased sweating and may cause nausea or interruption
of sleep. Hot flashes can be brought on by stress or heat, or they may occur for
no apparent reason at all. Studies have shown that the majority of the hot flashes
that men experience as a side effect of ELIGARD therapy are typically mild to moderate.
Severe hot flashes/sweats were seen in 1% and 3% of patients in the 7.5mg and 30mg
studies, respectively.
A healthy, balanced diet can do many things for you. In addition to boosting your
overall health and well-being, a healthy diet can:
- Fight 3 possible side effects of hormone therapy—decreased muscle mass, increased
fat mass, and weight gain
- Enhance your strength and energy level
- Increase the body's ability to tolerate side effects
- Decrease risk of infection
- Increase your ability to heal and recover quickly
A healthy diet means eating a variety of foods that provide the nutrients you need
to maintain your health. These nutrients include protein, carbohydrates, fat, water,
vitamins, and minerals. Watch the fat, though, since studies suggest that beef,
dairy, and other high-fat products may stimulate prostate cancer to grow.
A healthy diet also is important since elevated blood sugar and an increased risk
of developing diabetes have been reported in men receiving the drugs in ELIGARD’s
class. Your doctor will monitor your blood sugar levels. Increased risk of heart
attack, sudden death due to heart attack, and stroke has also been reported in men with
the use of the drugs in ELIGARD’s class. Your doctor will monitor you for heart
disease.
Michael J. Manyak, MD, is a paid consultant for sanofi-aventis U.S. A board-certified
specialist in urology, Dr. Manyak is Professor of Urology and Microbiology and Tropical
Medicine at George Washington University Medical School in Washington, DC, and Interim
Chairman of the Department of Urology at George Washington University Medical Center.
Dr. Manyak served as a urologic consultant for 9 years to the Medical Therapy of
Prostate Symptoms (MTOPS) multicenter study on prostate cancer and benign prostatic
hyperplasia (BPH), sponsored by the National Institute of Diabetes and Digestive
and Kidney Diseases. Currently, he serves as a consultant to the US Food and Drug
Administration Panel on Gastrointestinal and Genitourinary Devices. A fellow of
the American College of Surgeons, his memberships include the American Association
of Clinical Urologists, American Society for Laser Medicine and Surgery, Society
for Urologic Oncology, and the Society for Urology and Engineering.