Androgen Deprivation Therapy in Korea

Androgen Deprivation Therapy in Korea


Androgen Deprivation Therapy (ADT), also known as hormone therapy, is a primary treatment for prostate cancer. This therapy works by reducing the levels of male hormones (androgens, like testosterone) in the body, which prostate cancer cells often need to grow. In Korea, ADT is a standard and effective approach used in various stages of prostate cancer management.


Common Uses & Mechanisms in Korea

ADT is a cornerstone of prostate cancer treatment in Korea, used for several purposes:

  • Metastatic Prostate Cancer: Primary treatment for prostate cancer that has spread to other parts of the body.
  • Locally Advanced Prostate Cancer: Often combined with radiation therapy to improve outcomes for higher-risk localized or locally advanced disease.
  • Biochemical Recurrence: Used when PSA levels rise after initial treatments like surgery or radiation, indicating recurrence.
  • Neoadjuvant/Adjuvant Therapy: Can be given before or after other treatments to shrink the tumor or reduce recurrence risk.

Mechanisms: ADT works by:

  • Reducing Testosterone Production: Inhibiting the production of testosterone by the testicles.
  • Blocking Androgen Action: Preventing androgens from binding to receptors on prostate cancer cells.


Types & Administration

Several types of ADT are available in Korea:

  • Luteinizing Hormone-Releasing Hormone (LHRH) Agonists/Antagonists: These are injectable medications (e.g., leuprolide, goserelin, degarelix) that reduce testosterone production from the testicles. LHRH agonists cause an initial "flare" of testosterone, while antagonists do not.
  • Antiandrogens: Oral medications (e.g., bicalutamide, flutamide) that block androgen receptors, preventing testosterone from stimulating cancer cell growth.
  • Bilateral Orchiectomy: Surgical removal of the testicles, leading to an immediate and permanent reduction in testosterone. While effective, it's less commonly chosen due to its irreversible nature.
  • Newer Hormonal Agents: More potent oral medications (e.g., abiraterone, enzalutamide, apalutamide, darolutamide) that further suppress androgen production or block androgen signaling, often used for advanced or resistant prostate cancer.


Korean Guidelines & Practice

Korean urology and oncology guidelines align with international standards for ADT:

  • Tailored Treatment: The choice of ADT type and duration is highly individualized, based on the stage of cancer, PSA levels, Gleason score, patient age, comorbidities, and potential side effects.
  • Monitoring: Patients on ADT undergo regular monitoring of PSA levels, testosterone levels, bone density (due to potential bone loss), and management of side effects.
  • Side Effect Management: Common side effects include hot flashes, fatigue, decreased libido, erectile dysfunction, muscle loss, weight gain, and bone thinning. Korean clinics provide strategies and medications to manage these.
  • Intermittent ADT: In some cases, intermittent ADT (stopping and restarting treatment) may be considered to manage side effects, especially for non-metastatic disease.


Key Takeaways for ADT in Korea

To summarize the essential points about Androgen Deprivation Therapy in Korea:

  • Core Prostate Cancer Treatment: ADT is a fundamental hormonal therapy for various stages of prostate cancer.
  • Reduces Male Hormones: Works by lowering testosterone levels or blocking its action to inhibit cancer growth.
  • Multiple Options: Available as injections, oral medications, or surgically, chosen based on individual needs.
  • Managed Care: Treatment is highly personalized, with careful monitoring and management of side effects.

We hope this guide clarifies Androgen Deprivation Therapy in Korea. Always consult a qualified medical professional for personalized advice, diagnosis, and treatment.