Hormonal treatment for prostate cancer, why are they given late?

 Hormone Therapy is also known as Androgen Suppression Therapy (AST). The aim is to reduce the levels of male hormones, called androgen in the body, to stop them from fueling prostate cancer cells. Androgens stimulate prostate cancer cells to grow in the body. The two main androgens in the body are testosterone and dihydrotestosterone (DHT). Most androgen is made by testicles but the adrenal glands (situated above your kidney) as well as prostate cancer itself, can also make a fair amount. Hormone therapy alone cannot cure prostate cancer. Lowering androgens levels or stopping them from getting into prostate cancer cells often makes prostate cancer shrink or grow slowly. Prostate cancer treatment in India is provided by top-ranked hospitals.

What is Prostate Cancer?

Prostate cancer is the most common type of cancer in men. It occurs in the prostate gland — a small walnut-shaped gland that produces the seminal fluid that nourishes and transports sperm. If it is detected early, it has a better chance of successful treatment. The average prostate cancer treatment cost in India is 13,200 USD inclusive of medical evaluation, cost of surgery, hormone therapy if needed, and radiation.

Symptoms of Prostate Cancer:

• Frequent urination
• Bone Pain
• Change in bowel habits
• Trouble urinating (pain while passing urine)
• Blood in the urine and semen
• Weak or interrupted urine flow
• New onset of erectile dysfunction
• Discomfort or pain when sitting (caused by an enlarged prostate)

When is Hormone Therapy Used?

Hormone Therapy may be used in the following cases:

• If cancer comes back after the treatment with radiation therapy or surgery.
• Before radiation to try to shrink prostate cancer and make the treatment more effective.
• If cancer has spread too far to be cured by radiation or surgery or if you can’t have these treatments for some other reason.
• Along with radiation therapy as initial treatment, if you’re at high risk of cancer coming back after treatment.

Prostate cancer treatment in India includes several options depending on the condition of the patient. Men with advanced levels of prostate cancer are typically treated with drugs that cause testosterone levels to plummet. Testosterone is a hormone that fuels growing prostate tumors, so this treatment- Hormonal Therapy will stall the disease in its tracks. For this to happen, AST has to be administered correctly. But ideally, men get this treatment later than they should, causing testosterone levels to rise unacceptably. Rapid delays in treating these increasing testosterone may cause cancer progression.

Researchers conducted tests on nearly 23,000 men who were given AST injections. Each men’s treatment varied by how their AST was formulated. Some ASTs are given once a month while some are given in the intervals of 3–4 months or 6 months. The researchers wanted to find out how many men were late on their AST treatment and how that would affect the amount of testosterone in their blood. During this research, the team defined months in two different ways either a cycle of 28 days which is how months are defined in clinical terms or as a calendar month lasting 31 days.

After the result, 84% of treatments were late based on 1st definition i.e. cycle of 28 days meaning treatment was given after 28 days after the preceding ones. Of those treatments, around 60% were more than a week late and 29% were two weeks late. For the second definition, 27% of injections were given more than 32 days after the preceding ones. Of those treated, 13% were more than a week late and 9% were more than two weeks late.

Now, men who receive late injections were twice as likely to have high testosterone levels compared to the ones who received on time. For a set duration of therapy, AST is supposed to knock off testosterone down to below 20 nanograms per deciliter of blood as this correlates with better survival.

But among men who got late injections, testosterone in their blood climbed over the therapeutic target.

The researchers cited a number of reasons why AST is given so late often.

• Insurance companies might resist sometimes financial coverage if the dosing levels do not correspond to a calendar month.
• Transportation creates logistic issues for patients and clinics and patients with little to no information may not know how short delays can affect testosterone.

All these contribute to why some men do not experience the optimal response to hormonal therapies. There is also the need for continuous testosterone monitoring. As per the results, one month dose should be repeatedly given in every 28 days and a three-month dose should be repeatedly given in every 12 weeks. You can take help from medical assistance companies in India, who assist medical travelers across the globe to access Indian Healthcare in multi-specialty hospitals. Prostate cancer treatment in India is provided by top-ranked hospitals.

The average prostate cancer treatment cost in India is 13,200 USD inclusive of medical evaluation, cost of surgery, hormone therapy if needed and radiation.