Androgen deprivation therapy (ADT) enhances radiation therapy by regulating DNA repair. Since the prostate cancer cells thrive on dihydrotestosterone and testosterone, which are androgens. The prostate gland and PCa cells depend on androgens for their growth.
The androgens are mediums through which the activity of the healthy and cancerous cells is monitored. They help to activate androgen receptors which in turn regulate DNA repair genes to promote radioresistance in prostate cancer.
Radiation damages the cell’s DNA, making them incompetent. All body cells are designed to self-repair when exposed to threats such as radiation, ablation, and chemotherapy. But cancer cells can hijack the biochemical messengers responsible for the healthy survival of the body and use them.
Androgen deprivation therapy helps to control advanced prostate cancer when primary treatment has failed. It is also used to boost primary radiation therapy or extend the period of active surveillance. When androgen receptors are activated, the DNA repair genes are stimulated to help PCa cells survive when exposed to radiation.
It uses drugs to block the effects of androgens in the PCa cells and the body. The types of androgens used include:
• LHRH agonists – They help to prevent the pituitary gland from secreting the hormone responsible for producing androgens that shut off the flow. They include Zoladex and Lupron drugs, among other drugs.
• Androgen receptor antagonists – These are drugs such as bicalutamide, enzalutamide, apalutamide, or flutamide. They inhibit the androgens that bind to the androgen receptors.
• CYP17 inhibitor – The CYP17 inhibitors help to prevent prostate cancer cells from producing androgens in small amounts. The drug used for this purpose is Zytiga (abiraterone).
One study observed that when the androgen receptor signals are stimulated, the prostate cancer cells produce more DNA repair genes. These genes can increase the repair of the cells damaged by radiation.
When androgens trigger androgen receptors, the cancer cells can resist radiation. This concludes that androgen deprivation therapy increases the effectiveness of radiotherapy