peripheral hormonal blockade
The standard of care treatment for men with recurrent prostate cancer is often to place the patient on “castration” therapy that lowers a man’s testosterone to castration levels. This is associated with many side effects, including loss of sex drive, loss of muscle mass, loss of bone density, hot flashes, and lack of energy. When possible, we try to treat men with an alternative approach termed “peripheral blockade”. This therapy is taken orally in the form of two pills taken once a day, finasteride and bicalutamide. Taken together these pills block testosterone from activating prostate cancer cells to grow while leaving the man with a circulating testosterone (minimizing side-effects). We often give this therapy in an intermittent fashion to control cancer growth and to slow the ability of the cancer cells to become resistant. For some men, this may be an alternative to starting testosterone - lowering therapy and to control their cancer. It is not a standard of care approach.
