title: The time for serum testosterone to reach castrate level after bilateral orchiectomy or oral estrogen in the management of metastatic prostatic cancer.
abstract: OBJECTIVE
  To understand the time for serum testosterone to reach castrate level after bilateral orchiectomy or oral estrogen in the management of metastatic prostatic cancer.
  
  
  METHODS
  A total of 20 consecutive patients with adenocarcinoma of the prostate with bony metastasis were enrolled in this study. Their mean age was 72.8 years old (range, 57 to 82 years). Pretreatment serum testosterone levels were obtained in all men. Thirteen men were treated with bilateral orchiectomy. Immediately after removal of testes, serial blood samplings for serum testosterone levels were drawn every fifteen minutes for the first two hours, then hourly for another sixteen hours. Seven men were treated with oral estrogen diethylstilbestrol (DES), 3 mg per day. Serum testosterone levels were checked on a weekly basis for two months, and then biweekly for another two months.
  
  
  RESULTS
  Castration time of bilateral orchiectomy ranges from three to twelve hours (mean, 8.6 hours). The biological half-life of serum testosterone was from thirty to sixty minutes (mean, 45 minutes). Castration time of oral estrogen (DES) was from twenty-one to sixty days (mean, 38.3 days).
  
  
  CONCLUSIONS
  Bilateral orchiectomy and oral estrogen were both effective ways of castration for patients with bony metastatic prostatic cancer. Bilateral orchiectomy provides a more rapid castration and is one hundred seven times faster than oral estrogen in reaching castrate level.
authors.affiliation: Department of Surgery, Veterans General Hospital-Taipei, Taiwan, Republic of China.
authors.forename: B J
authors.initials: BJ
authors.lastname: Lin
authors.forename: K K
authors.initials: KK
authors.lastname: Chen
authors.forename: M T
authors.initials: MT
authors.lastname: Chen
authors.forename: L S
authors.initials: LS
authors.lastname: Chang
mesh_terms: D000230:Adenocarcinoma / Q000097:blood* / Q000556:secondary / Q000628:therapy*; D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000097:blood / Q000556:secondary; D004054:Diethylstilbestrol / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009919:Orchiectomy; D011471:Prostatic Neoplasms / Q000097:blood* / Q000473:pathology / Q000628:therapy*; D013739:Testosterone / Q000097:blood*; D013997:Time Factors
chemical_list: D013739:Testosterone; D004054:Diethylstilbestrol