BERKELEY, CA (UroToday.com) - We now actively recommend surgical castration for patients with castration-refractory prostate cancer on LHRH agonists.
It is partly because it is very improbable that they can successfully escape from androgen deprivation therapy and partly because there are patients who cannot afford to continuously pay the cost of LHRH agonists even in the country with the third (not second anymore) largest GDP in the world and once well-functioning health insurance systems. Japan has been suffering from a deep recession for a long time and was recently fascinated by a nuke again. Additionally, elderly patients and their family have difficulty in frequently visiting hospitals, surgical castration may free patients of them in part.
The testosterone levels achieved by surgical castration are significantly lower than those achieved by medical castration. With the recent understanding of molecular mechanisms of acquiring androgen independency in prostate cancer, the lower testosterone levels may occasionally cause the more benefit in the oncological control of ‘castration-refractory’ prostate cancer. We suppose that this theory needs and is worth further investigation.
Written by:
Takumi Takeuchi, MD. as part of Beyond the Abstract on UroToday.com. This initiative offers a method of publishing for the professional urology community. Authors are given an opportunity to expand on the circumstances, limitations etc... of their research by referencing the published abstract.
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