The next treatment modality is androgen deprivation therapy. For this, we first have to understand the hormonal axis causing the testosterone release.
The pituitary gland releases LH and FSH, which directly acts on the testis to release testosterone.
ACTH released from the pituitary gland acts on the adrenal gland to release DHEA, which subsequently gets converted into testosterone.
The testosterone released from testis and adrenal gland enters the prostate cell and gets converted into DHT which causes the growth and survival of prostate cancer cells.
We can block this pathway, to reduce the action of testosterone on prostate cancer cells. GnRH agonists or antagonists prevent the release of LH, FSH, and ACTH from the pituitary gland.
Then come the cytochrome 17P inhibitors that prevent the release of testosterone from the testis and adrenal gland. And finally, there are androgen receptor blockers that prevent the binding of testosterone to prostate cancer cells, thereby preventing its action.
Another method for androgen deprivation is surgical castration in which both testes are removed. Unlike medical construction, it is a one-time procedure.
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