Ovarian ablation therapy

For women, the ovaries are a very important part of their body. And the ovaries are the part used for reproduction. However, many women who have already given birth do not want ovaries. Because ovarian cancer will increase the risk of tumor cancer to a certain extent. If you undergo ovarian castration, you can also avoid taking birth control pills, etc., which can alleviate physical damage to a certain extent.

This is because the growth of breast cancer cells is related to the constant stimulation of estrogen. The ovaries are the main organs that produce estrogen in premenopausal women. Ovariectomy can reduce or block the effect of female hormones on tumors, thereby causing tumor regression. Its efficacy is related to the level of estrogen receptors, which can be detected in the resected tumor specimens. For example, in cases with positive estrogen receptors, the efficacy can reach 60%; in cases with negative estrogen receptors, the efficacy is 10% to 20%; and in unselected cases, the efficacy is 30% to 40%. Moreover, the remission period for effective cases was longer, averaging 30 months, while that for ineffective cases was only 9 months. It can be seen that removing the ovary is one of the effective means of treating premenopausal patients with advanced breast cancer.

Now I will explain to you in detail why castration is used to treat prostate cancer.

Patients with metastatic prostate cancer have significant therapeutic effects after surgical castration or taking high-dose estrogen. Orchiectomy and taking high-dose estrogen have always been the gold standard for endocrine therapy of prostate cancer. Although this treatment can only block testosterone from the testicles, there are still reports that the condition can be effectively controlled in 60% to 70% of patients. However, serious adverse cardiovascular reactions limit the clinical application of high-dose estrogen; the double blow to patients' psychology and physiology and the irreversibility after surgery also affect the widespread application of orchiectomy.

Since 95% of the testosterone in the human prostate comes from the testicles, but the concentration of dihydrotestosterone (DHT) in the prostate is only reduced by 60% after castration, the remaining 40% comes from the adrenal glands. In order to block adrenal androgens, the concept of castration plus androgen receptor antagonist total androgen blockade (MAB) was proposed. A large number of meta-analyses of clinical data have found that total androgen blockade can improve patients' survival rate and objective remission rate.

For patients with localized or locally advanced prostate cancer, radiotherapy and adjuvant endocrine therapy after radical surgery can significantly improve the overall survival rate of patients. Bolla et al. reported the results of a randomized study of 415 patients with stage T3 prostate cancer: the 5-year survival rate of the radiotherapy alone group was 62%, while the 5-year survival rate of the radiotherapy + goserelin group was 79%; the 5-year disease-free survival rate of the radiotherapy alone group was 40%, while that of the radiotherapy + goserelin group was 75%; the 5-year local lesion control rate of the radiotherapy alone group was 79%, while that of the radiotherapy + goserelin group was 97%. The above research results show that the combined use of goserelin as adjuvant therapy for patients with early prostate cancer at the beginning of radiotherapy can significantly improve the patients' overall survival rate, disease-free survival rate and local lesion control rate.