Genitourinary & Reproductive Cancers
Prostate cancer and androgen deprivation, bladder and kidney cancer therapy, and gynaecological and testicular cancers.
Prostate Cancer: Androgen Deprivation and Beyond
Almost every prostate cancer begins as a hormone addict. Its cells grow because testosterone, converted to the more potent DHT, docks onto the androgen receptor and tells the tumour to divide. So the single most powerful thing you can do for advanced disease is not to poison the cancer but to starve it — to switch off the androgens it depends on. That idea, androgen deprivation, is the spine of prostate-cancer pharmacology: a series of drugs that attack the same hormonal axis at different points, from the brain down to the receptor itself.
Bladder and Kidney Cancer: Intravesical Therapy, Immunotherapy and TKIs
Two cancers sit a few centimetres apart in the urinary tract, yet their drug stories could hardly be more different. The bladder is a hollow bag you can fill with a drug and drain an hour later — so its earliest cancers are treated by pouring medicine straight in, bathing the tumour while the rest of the body barely notices. The kidney's cancer refused chemotherapy entirely, and forced oncologists to attack its biology instead — the faulty gene that makes it grow its own blood supply. One organ taught us local therapy; the other taught us targeted therapy. Together they are a masterclass in matching the route and the mechanism to the tumour.
Gynaecological and Testicular Cancers: Platinum, PARP and Hormones
The reproductive organs give oncology two of its most remarkable stories. Testicular cancer, once a young man's death sentence, is now cured with chemotherapy even after it has spread — one of medicine's cleanest triumphs. And ovarian cancer, long treated with blunt poison, became the showcase for the targeted era: platinum to knock the tumour down, then a PARP inhibitor to keep it down by exploiting the tumour's own broken DNA-repair machinery. This chapter is a tour of the drugs that fight cancers of the ovary, uterus, cervix and testis — platinum, PARP, hormones and vaccines — and why each disease demands a different weapon.
