LHRH agonists may cause a flare response during the first 3 weeks of treatment. While androgen blockade can limit disease progression and reduce urinary outlet obstruction, it is associated with several adverse effects.
Although administering an antiandrogen just prior to initiating treatment with an LHRH agonist can reduce the risk of a flare response, it does not completely eliminate that risk.
One advantage of LHRH antagonist therapy is the avoidance of a flare response and a more immediate drop in testosterone than with LHRH agonists.
An indication for immediate bilateral orchiectomy is spinal cord compression, because it avoids the potential flare response that can occur during the first 3 weeks of treatment with an LHRH agonist.
To learn more about the management of advanced and metastatic prostate cancer, read here.
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Cite this: Bradley Schwartz. Fast Five Quiz: How Much Do You Know About Prostate Cancer Treatment? - Medscape - Apr 04, 2019.