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Is Leuprolide (Lupron) a Safe and Effective Treatment for Prostate Cancer?

Overview

Lupron is a brand name for leuprolide acetate, a luteinizing hormone-releasing hormone (LHRH) agonist. LHRH is a naturally occurring hormone that stimulates the production of testosterone in the testes. Lupron effectively blocks LHRH, so it reduces the amount of testosterone in your body.

Lupron is a type of hormone therapy used to treat prostate cancer, which is powered by testosterone.

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Efficacy

How effective is it for the treatment of prostate cancer?

Male hormones give prostate cancer cells the fuel they need to grow and spread. The goal of hormone treatments, such as Lupron, is to deprive cancer cells of this fuel to slow disease progression. That said, Lupron is not a cure for prostate cancer. Rather, it works to slow down the growth and spread of the cancer.

Use in women
This drug is sometimes prescribed for women who have endometriosis or fibroids. In those cases, it lowers estrogen production.

Lupron can be used to treat any stage of prostate cancer, but it’s usually used for recurrent or advanced cancers. In men with early-stage prostate cancer who don’t want surgery or radiation, there is no evidence that hormone therapy is more effective than watchful waiting or active surveillance, according to the American Cancer Society.

Drug resistance

There’s some disagreement about when to begin hormone therapy. While starting hormone therapy earlier may help slow disease progress, there’s also a chance that the cancer will become resistant to the drug earlier. For some men, Lupron initially slows down progression, but then the cancer becomes resistant and stops responding to treatment. Some cancer cells may also continue to grow, even without an abundance of testosterone. For those reasons, some doctors recommend intermittent therapy.

There’s no way to know for certain how long the treatment will continue to work. It could be anywhere from a few months to a few years.

Monitoring effectiveness

How this drug will work for you is hard to predict. Your doctor will monitor your prostate-specific antigen (PSA) levels to gauge how well it’s working. PSA is a protein produced in the prostate and circulated in the blood. Periodic blood tests can track rising or falling PSA levels. PSA levels on the rise would indicate that hormone treatment isn’t working.

Learn more: PSA levels and prostate cancer »

Side effects

What are the possible side effects?

When you first start using Lupron, you may have a temporary rise, or flare, in testosterone levels. This can make symptoms of advanced prostate cancer worse, but it should last for only a few weeks. Depending on where your tumors are located, these symptoms could include:

  • bone pain
  • problems with urination
  • ureteral obstruction
  • aggravation of nerve symptoms
  • spinal cord compression

A small amount of testosterone comes from the adrenal glands, but most is made in the testicles. The drug can suppress testosterone production in the testicles to the point of chemical castration. This means that in some cases, the drugs could lower the testosterone level as much as surgical removal off the testes could.

Other potential side effects of Lupron can include:

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Dosage

What’s the typical dosage?

Hormone therapy can be used alone or in combination with other therapies. It may also be used before or after other therapies.

Lupron is administered by injection. The dosage will vary according to your particular situation. Here are some typical dosage options your doctor may prescribe:

  • 1 mg once per day, varying the injection site
  • 7.5 mg every 4 weeks
  • 22.5 mg every 12 weeks
  • 30 mg every 16 weeks
  • 45 mg every 24 weeks

If you stop taking Lupron, you’ll start producing testosterone again.

Doctor

Talking with your doctor

You will experience some changes when your hormone levels fluctuate or have a substantial drop. It’s a good idea to talk about this in advance so you’re not caught off guard.

Consider asking some of these questions when you consult with your doctor:

  • Why do you recommend treatment with Lupron?
  • How often will I have to take the drug?
  • Will I administer it myself or will I need to come in to the clinic?
  • How often will we test to see if it’s working?
  • How long will I have to take it?
  • What should I do if I miss a dose or if I stop taking it?
  • What are the potential side effects, and can we do anything about them?
  • Are there any other medications, supplements, or foods I should avoid while taking Lupron?
  • If it doesn’t work, what are the next steps?
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Outlook

What’s the outlook?

According to the American Cancer Society, the relative five-year survival rates for men with prostate cancer, compared to men without the disease, are:

  • Almost 100 percent for local stage cancer that has not spread outside the prostate
  • Almost 100 percent regional stage cancer that has spread to nearby areas
  • About 28 percent for distant stage cancer that has spread to distant sites

These are general estimates. Your individual outlook depends on a variety of influences, such as your age, overall health, and stage at diagnosis. If this is a recurrence of prostate cancer, previous treatments may affect your options now.

Your doctor can give you an idea what to expect from your treatment with Lupron.

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Other options

Other treatment options

Leuprolide is also sold under the brand name Eligard. Aside from Lupron and Eligard, there are other hormone therapies for prostate cancer as well. Learn more about other prostate cancer drugs.

Your doctor may also recommend surgery, radiation, or chemotherapy. In some cases where hormone treatment is no longer effective, a cancer vaccine can help prompt your immune system to attack cancer cells. Ask your doctor if this is an option for you.

Read next: The 11 best cancer blogs of the year »

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