Prostate cancer is a serious health problem, but it is also manageable.
Various therapies and treatment approaches are available to tackle this common disease.
One of these therapies for prostate cancer is the use of Lupron.
If you’ve ever wanted to know about Lupron and how it works, you came to the right place.
Read on to learn more about this therapy and whether it’s effective in the first place.
What is Lupron (leuprolide)?
Lupron is a brand name for generic leuprolide acetate, a medication used in combination with other treatment approaches to manage prostate cancer.
As a synthetic hormone, Lupron is also used to treat endometriosis, uterine fibroids, and other sex hormone-associated conditions.
Lupron belongs to the class of drugs called LHRH agonists (also known as a gonadotropin-releasing hormone, i.e., GnRH agonist).
Here, LHRH stands for luteinizing hormone-releasing hormone. The primary purpose of these medications is to block the production of LHRH in the body to lower testosterone production.
The drug has been around for decades. Lupron got FDA approval for the treatment of advanced prostate cancer back in April 1985. Four years later, in January 1989, FDA also approved Lupron depot for monthly intramuscular injection for palliative treatment of advanced prostate cancer.
How does it work?
The class of drugs to which Lupron belongs speaks a lot about its mechanism of action. Leuprolide acetate works to suppress gonadotrope secretion of follicle-stimulating and luteinizing hormone (LH). This action eventually inhibits gonadal sex steroid production.
A more detailed explanation would be the following.
At first, administration of Lupron stimulates pituitary gland gonadotropins luteinizing hormone, and follicle-stimulating hormone (FSH).
As a result, steroidogenesis in a man’s testicles increases.
When that happens, men may have elevated serum testosterone and dihydrotestosterone levels.
This is called tumor flare when the initial stages of treatment worsen symptoms of the disease.
That said, continuous administration of Lupron decreases gonadotropins and gonadal steroids.
With time, consistent administration of leuprolide acetate lowers the concentration of serum testosterone levels by inhibiting LH and FSH.
Decreasing testosterone levels may help slow prostate cancer growth.
How effective is it for treating prostate cancer?
Although Lupron for prostate cancer is not a novel idea, studies on this subject are scarce. Current evidence confirms administration of leuprolide acetate can, indeed, suppress the production of testosterone, i.e., it is effective for androgen deprivation.
Not only is leuprolide effective in suppressing testosterone, but it is also well-tolerated.
Not every patient with prostate cancer will need to take Lupron. Doctors recommend and prescribe leuprolide acetate to men with late-stage prostate cancer.
It’s highly unlikely for most doctors to start treating early-stage prostate cancer with hormonal therapies, including Lupron.
Doctors may prescribe Lupron for cases when cancer comes back after surgery or radiation therapy.
Hormone therapy such as Lupron may be recommended to patients whose cancers spread too much for radiation therapy and surgery to cure it.
Doctors may also recommend Lupron to shrink cancer before employing radiation therapy.
Prostate cancer patients undergoing radiation therapy and having a high risk of cancer returning may also get a prescription for Lupron therapy.
Now you’re probably wondering why doctors can’t start with hormonal therapy such as Lupron at early prostate cancer stages? What’s stopping them?
In theory, starting hormone therapy in the early stages of a disease could delay its progression and make treatment easier.
However, cancer may become resistant to the medication and stop responding to the treatment.
Even with suppressed testosterone production, some cancer cells may keep growing. That’s why a doctor may choose not to go for hormone therapy right away.
What to expect during treatment?
Hormone therapies are usually not standalone treatments for prostate cancer. Therapies such as Lupron injection are often administered in combination with radiation therapy or after surgery.
Lupron is administered as a depot. The term depot here refers to an injection of a certain medication that is implanted under the skin. Then, the depot releases the medication slowly over time.
Patients can choose the injection site. You can opt for buttocks, arms, or outer thighs, like any other injection.
The dosage of Lupron may vary from one patient to another. The doctor is the one who recommends the most suitable dosage for each patient.
Typical doses include 1mg once a day (varying the injection site) or 7.5mg every four weeks. Other dosages of Lupron include 22.5mg every 12 weeks, 30mg every 16 weeks, and 45mg every 24 weeks.
Before you start the treatment, make sure to ask your doctor about everything you want to know. The doctor will explain how Lupron works, what you can expect, and address other concerns you may have.
Any type of medication comes with a certain risk of adverse reactions, and Lupron is not the exception.
When you start receiving Lupron injections, you may experience a temporary increase in testosterone levels.
Elevated testosterone may worsen advanced prostate cancer.
Remember, this effect is temporary, and the exact symptoms depend on the location of the tumors.
They may include:
- Urination problems
- Bone pain
- Compression of spinal cord
- Ureteral obstruction
- Worsening of nerve symptoms
Not all men will experience higher testosterone levels due to Lupron. Some patients may have the opposite effect, i.e., testosterone suppression.
Most testosterone is produced in testicles and only a small amount in adrenal glands. Lupron may suppress the production of male hormones in the testicles.
Suppression of testosterone production is comparable to surgical removal of testes.
Lupron injection may have many other side effects, such as:
- Hot flashes, night sweats
- Increased sweating
- Tiredness or weakness
- Upset stomach
- Diarrhea or constipation
- Stomach pain
- Pain in muscles or joints
- Difficulty sleeping
- Low libido
- Swelling of feet or ankles
- Increased urination at night
- Memory problems
- Impotence (erectile dysfunction)
- Shrunken testicles
- Weight gain
- Skin reaction at the injection site
- Mood swings
- Changes in blood lipids
- Insulin resistance
Consult adverse reactions with your healthcare provider. In many cases, these side effects are temporary.
About 80% to 85% of prostate cancers are detected in regional or local stages. These are the cancer stages we call I, II, and III. Most patients diagnosed and treated when cancer is in regional or local stages are disease-free after five years.
American Cancer Society reports the five-year prostate cancer survival rate depends on the stage. For example, localized prostate cancer and regional prostate cancer have nearly 100% five-year survival rates.
On the other hand, distant or metastatic prostate cancer has a five-year survival rate of 30%. All stages combined have a five-year survival rate of 98%.
Since most prostate cancers are diagnosed early, the long-term prognosis is encouraging. For that reason, men need to go to prostate cancer screenings.
At the same time, doctors and patients have the opportunity to explore different approaches to treat this disease.
Alternative treatment options
Lupron is not the only type of hormone therapy or androgen deprivation therapy to treat metastatic diseases such as prostate cancer. Other therapies to lower androgen levels include:
Orchiectomy (surgical castration)
This involves surgical removal of testicles to allow prostate cancer to stop growing or shrink for a while. It is the least expensive type of hormone therapy.
Unlike other approaches, surgical castration is permanent. Many men struggle to accept and deal with the removal of testicles.
Other LHRH agonists
Other LHRH agonists such as Goserelin (Zoladex), Triptorelin (Trelstar), Histrelin (Vantas), and Leuprolide mesylate (Camcevi).
As mentioned above, treatment with LHRH agonists is often called medical castration. The reason is simple – these therapies lower androgen levels just as successfully as surgical castration.
Such as Degarelix (Firmagon) and Relugolix (Orgovyx) – their mechanism of action is slightly different than that of LHRH agonists. That said, LHRH antagonists decrease testosterone levels faster.
At the same time, the therapy doesn’t cause tumor flare like LHRH agonists. Treatment with these therapies is also considered a form of medical castration.
Hormone therapy may also include treatment to decrease androgen levels from adrenal glands and drugs that stop androgens from working, i.e., anti-androgen therapies.
Also called androgen receptor antagonists, anti-androgen therapies connect to androgen receptors to prevent them from supporting cancer growth. You take these drugs daily, in pill form.
It’s helpful to mention hormone treatment could be useful for cases of castration-resistant prostate cancer.
In addition to hormone therapy, prostate cancer treatment may also include chemotherapy, immunotherapy, targeted therapy, cryotherapy, radiation therapy, and surgery such as open or laparoscopic radical prostatectomy.
The doctor recommends the most suitable treatment based on the stage of prostate cancer, symptoms, and overall health. Lifestyle adjustments to support the health of the prostate are also necessary during this time.
The main focus of this post was Lupron for prostate cancer. Hormone therapy has a simple mechanism of action, but more research is necessary to uncover all its effects.
Doctors usually recommend this therapy to patients with advanced prostate cancer. Since cancer can become resistant to hormone therapy, doctors typically choose not to recommend the therapy in the early stages of prostate cancer.
The therapy could induce various side effects after the first use, but they may be temporary as the body adjusts.
Now, read our ultimate Guide to Prostate Supplements.