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.
Department of Surgery, Pritzker School of Medicine, University of Chicago, Illinois.
R I
RI
Silver
F H
FH
Straus
N J
NJ
Vogelzang
H
H
Kellman
G W
GW
Chodak
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