Prostate Cancer

Prostate cancer is a prevalent type of cancer that develops in the prostate gland, a small organ in men responsible for producing seminal fluid. This cancer usually grows slowly and often does not cause symptoms in its early stages. However, some varieties can be aggressive and spread quickly.

Types of Prostate Cancer

Most prostate cancers are adenocarcinomas, which arise from the glandular cells of the prostate. Less common variants include:

• Small cell carcinomas

• Squamous cell carcinomas 

• Transitional cell carcinomas   

Hormone-Sensitive vs. Castration-Resistant Prostate Cancer

• Hormone-Sensitive Prostate Cancer (HSPC):  This type relies on androgens (male hormones such as testosterone) for growth. Reducing androgen levels through androgen deprivation therapy (ADT) can slow or halt its progression.

  
  

• Castration-Resistant Prostate Cancer (CRPC):  Over time, some prostate cancers may become resistant to ADT. CRPC continues to grow despite low testosterone levels and often requires additional treatments targeting different pathways or resistance mechanisms.

Common Medications for Prostate Cancer

1) Androgen Deprivation Therapy (ADT):

• LHRH agonists/antagonists: Leuprolide, Goserelin, Degarelix, Relugolix (Lupron, Orgovyx)

• Orchiectomy: Surgical removal of the testicles (rarely used now) 

2) Anti-Androgens: 

• Bicalutamide, Enzalutamide, Apalutamide (Xtandi, Erleada) These medications block androgen receptors to inhibit cancer growth.

3) Androgen Synthesis Inhibitors or ASTI or ARTA: 

• Abiraterone acetate (Zytiga): Prevents androgen production from the adrenal glands and the tumor itself.

4) Chemotherapy: 

• Docetaxel, Cabazitaxel (Taxotere, Jevtana): Used in later stages or resistant cases.

5) Immunotherapy and Targeted Therapy: 

• Sipuleucel-T (Provenge): For select patients with metastatic CRPC. 

6) PARP inhibitors (e.g., Olaparib, Lymparza): Effective for tumors with DNA repair gene mutations.

7) Radiopharmaceuticals**: 

• Radium-223 (Xofigo), lutetium Lu 177 vipivotide tetraxetan (Pluvicto): used for bone-dominant metastatic CRPC.

Treatment options vary based on the disease stage, the patient’s overall health, and previous therapy responses.