February 25, 2020
Dr. Lawrence F. Domingo, M.D.
Prostate cancer is a slow-growing as a tumor. Doubling times for local disease calculated at 2 - 4 years. It is the 2nd most common cause of cancer death in men in the United States. There was 230,110 new cases and 29,900 deaths from the disease in the year 2004. Prostate cancer is treated with surgical resection, radiation or antiandrogen therapy. The tumor then can become highly aggressive and be metastatic androgen-independent.
In the advent of pharmaceutical advances, Alpha1 adrenoceptor antagonists are being investigated for treatment of prostate cancer patients.
This study aims to investigate the use Alpha1 adrenoceptor antagonists for prostate cancer patients, the different types of current medications available and novel drugs, the pharmacology of each medication, their clinical uses and side effects.
Alpha1 adrenoceptor antagonists are the first-line of lower urinary tract symptoms due to BPH. It can be co-administered with antihypertensive drugs in combination. Multicenter, double-blind, randomized, placebo-controlled studies have established that terazosin, doxazosin, and tamsulosin are relatively safe drugs. They are sustained for a longer duration. There is no effect on the rate of proliferation but targeted in activating apoptosis. Apoptotic action on benign cells and cancer cells and to both androgen-independent and androgen-sensitive. Apoptotic potency was specific to these medications. Tamsulosin did not elicit any apoptotic effect against prostate cells. Gefitinib (EGFR inhibitor ZD1839) a novel druge, induce apoptosis and inhibit proliferation of prostate cancer cells in vitro. Further investigation is warranted for this.
Prostate tumor cells evade apoptosis and promote angiogenesis during progression. Doxazosin and terazosin, can induce apoptosis in benign and malignant prostate cells. Reconstitution of apoptotic pathways offer therapeutically and feasible treatment options not only for prostate cancer but possibly for other human malignancies. Doxazosin and terazosin, can induce apoptosis in benign and malignant prostate cells.
The article The Role of Alpha-Blockers in the Management of Prostate Cancer by Tahmatzopolous et. al. has discussed the advancement of the medical field and that cancer treatment has advanced the same way. For prostate cancer, Alpha1 adrenoceptor antagonists is the recommended first line for treatment. Doxazosin and terazosin manages the lower urinary symptoms and elicits apoptosis to both benign and malignant prostate cancer cells. With this study, these two medications is recommended for use. Gefitinib needs further investigation so that it could be added to the arsenal of medications used. A local study about these medications is deemed fitting as prostate cancer is also with high mortality and morbidity in the Philippines. Thank you.