Thérapie de privation androgénique chez un patient atteint d'un cancer de la prostate avancé

Dernière mise à jour : 18 mai 2026

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In this topic, we will remain focusing on androgen deprivation therapy (ADT) in advanced prostate cancer patients. Testosterone plays a major role in prostate cancer aggressiveness; therefore, we try in every way to suppress this hormone to control disease progression.

• Centre d'urologie Hôpital de Bangkok Thaïlande Réservation en ligne 02-310-3009 bhquro@bdms.co.th
• Hôpital Samitivej Sriracha Chonburi 088-022-1445

In the past, the only way to perform androgen deprivation therapy was a bilateral orchiectomy (surgical testicular removal), which dramatically suppressed testosterone by removing the primary production organ. However, confirmed reports showed that patients who underwent orchiectomy sometimes confronted psychological trauma from this irreversible procedure.

Currently, modern medical ADT has been developed. These preparations come as subcutaneous or intramuscular injections with intervals ranging from 1 month to 1 year. Regular serum testosterone measurement is still required to confirm adequate suppression.

Exemples de Medical Androgen Deprivation Therapy

1. Enantone (Leuprolide)
   • 95%–98.8% complete testosterone suppression reported (cut-off: <50 ng/dL)
2. Zoladex (Goserelin)
   • 96% complete testosterone suppression reported (cut-off: <20 ng/dL)

My current practice is 3-month interval intramuscular injection with regular monitoring including:

1. PSA (Prostate Specific Antigen) — using PSA Doubling Time to assess cancer activity
2. Testosterone level — target <50 ng/dL per NCCN 2021 guideline

The current practice in prostate cancer management keeps updating every 3 months. This is just one small aspect of prostate cancer care — discussing your treatment with an up-to-date Uro-Oncologist is essential for a tailor-made androgen deprivation therapy.

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Frequently Asked Questions About Androgen Deprivation Therapy (ADT)

What is androgen deprivation therapy and why is it used in prostate cancer?

Androgen deprivation therapy (ADT) is the primary systemic treatment for advanced prostate cancer. Testosterone fuels prostate cancer cell growth and aggressiveness, so ADT works by suppressing testosterone to castrate levels (<50 ng/dL). This can be achieved surgically through bilateral orchiectomy or medically through regular injections of LHRH agonists such as Leuprolide (Enantone) or Goserelin (Zoladex).

What is the difference between surgical and medical ADT?

Surgical ADT (orchiectomy) is a one-time irreversible procedure that permanently removes the testosterone-producing testicular tissue. It is highly effective but can cause significant psychological impact. Medical ADT uses injectable LHRH agonists at intervals of 1 month to 1 year, achieving 95–98.8% testosterone suppression. Medical ADT requires ongoing injections and regular testosterone monitoring to confirm adequate suppression, but preserves the option to discontinue treatment.

How is ADT treatment response monitored?

Treatment response is monitored every 3 months through PSA measurement — specifically PSA Doubling Time to track cancer activity — and serum testosterone levels targeting below 50 ng/dL per NCCN guidelines. Rising PSA on ADT may indicate disease progression and the need to consider additional second-line treatments. Regular follow-up with a Uro-Oncologist is essential for timely treatment adjustment.

If you or a family member has been diagnosed with advanced prostate cancer and requires ADT consultation, Dr. Soarawee Weerasopone offers specialist consultations at Bangkok Hospital Headquarters. Prendre rendez-vous.

Avis de non-responsabilité : Ce contenu est rédigé et revu par le Dr Soarawee Weerasopone, urologue certifié au siège de Bangkok Hospital. Il est destiné uniquement à des fins éducatives et ne constitue pas un avis médical. Consultez toujours un professionnel de la santé qualifié avant de commencer tout traitement médical.