A new option in hormonal therapy for advanced prostate cancer
The Food and Drug Administration approved a new type of hormonal therapy for men with advanced prostate cancer in December 2020. Instead of traveling to a medical office to obtain an injection of a medication to suppress testosterone, men could swallow a tablet.
The medication, relugolix, “has been a significant improvement, especially during the COVID-19 pandemic era,” says Upstate urologic oncologist Hanan Goldberg, MD. “We tried to limit patients coming to the hospital or the clinic because cancer patients are more at risk of COVID-19.”
Androgen deprivation therapy – to suppress male hormones – may be prescribed to slow the growth of prostate cancer cells, and it has been shown to extend the lives of men with advanced prostate cancer. The oral and injectable medications are likely to produce the same side effects: hot flashes, fatigue, mood swings and others. Goldberg tells his patients it’s similar to menopause.
He notes one important difference with the oral medication. A study published in the New England Journal of Medicine found a 54 percent lower risk of major cardiovascular side effects in men who took relugolix, compared with those who had injections. “For patients who have prostate cancer but also have cardiovascular issues going on, this drug is probably preferable.”
A main advantage of relugolix, Goldberg says, “is the higher percentage of patients who recover their testosterone to normal range 90 days after stopping treatment, compared to those treated with injections (54% vs. 3%).”