Response to orchiectomy following Zoladex therapy for metastatic prostate carcinoma.
Serum testosterone and prostate-specific antigen (PSA) levels were measured in 3 patients with Stage D2 prostate cancer before and after discontinuation of the long-acting LHRH agonist, goserelin acetate (Zoladex). The patients had received goserelin acetate for ten, sixteen, and thirty months prior to discontinuing the drug because of progressive metastatic disease. In all 3 patients, PSA and testosterone levels increased after goserelin acetate was discontinued. In 2 patients the testosterone level reached normal levels. A bilateral orchiectomy was performed one hundred sixty, one hundred, and seven days, respectively, after the drug was discontinued. In all 3 cases PSA and testosterone levels were reduced following castration, although PSA levels again began to increase within two weeks of orchiectomy in 2 of the 3 patients. These findings suggest that suppression of testosterone by LHRH agonists is not permanent and if tumor progression occurs, maintaining hormone suppression may still be beneficial.
Silver
R I
RI
Department of Surgery, Pritzker School of Medicine, University of Chicago, Illinois.
Straus
F H
FH
Vogelzang
N J
NJ
Kellman
H
H
Chodak
G W
GW
D000368:Aged; D000951:Antigens, Neoplasm / Q000097:blood; D002064:Buserelin / Q000031:analogs & derivatives* / Q000627:therapeutic use; D003131:Combined Modality Therapy; D017273:Goserelin; D006801:Humans; D008297:Male; D009919:Orchiectomy; D017430:Prostate-Specific Antigen; D011471:Prostatic Neoplasms / Q000097:blood / Q000473:pathology / Q000628:therapy*; D013739:Testosterone / Q000097:blood
D000951:Antigens, Neoplasm; D017273:Goserelin; D013739:Testosterone; D017430:Prostate-Specific Antigen; D002064:Buserelin