Two methods of castration treatment for prostate cancer

Castration therapy is a type of endocrine therapy for prostate cancer, and endocrine therapy is mainly used for patients with advanced prostate cancer, biochemical recurrence after radical surgery/radiotherapy, as well as neoadjuvant therapy and postoperative adjuvant therapy. Castration therapy for prostate cancer can include surgical castration and medical castration, and there is no significant difference in the treatment effect between the two.

Surgical castration

Surgical castration is simple to perform and there is little chance of postoperative complications, but attention should be paid to the patient's psychological stress.

Medical castration

Medical castration is increasingly being used because it does not require surgery and reduces the psychological barriers for patients and their families. Currently, the most commonly used drug in clinical practice is luteinizing hormone-releasing hormone analog (LHRHa). However, there will be a transient increase in testosterone in the early stages of LHRHa injection, so anti-androgens should be taken in advance or at the same time as the first dose. This transient increase in testosterone may lead to aggravation of clinical symptoms, such as bone pain, acute urinary retention, obstructive renal failure, spinal cord compression, and fatal cardiovascular diseases caused by hypercoagulable state. Patients who already have bone metastases leading to acute spinal cord compression need special screening.

Common side effects of castration therapy for prostate cancer

Decreased libido, erectile dysfunction, paroxysmal hot flashes, breast tenderness, and decreased bone density and anemia caused by long-term low androgen status are common side effects of castration therapy for prostate cancer. A small number of patients may also experience personality changes and decreased cognitive abilities.