Stronger suppression of serum testosterone and FSH levels by a synthetic estrogen than by castration or an LH-RH agonist.
Serum levels of LH, FSH and testosterone (T) were measured by radioimmunoassays in 36 patients with advanced prostate cancer before and during androgen ablation therapies. Both leuprolide acetate (LH-RH agonist: LHRH-A) and diethylstilbestrol diphosphate (DES-DP) administration decreased serum LH significantly to an undetectable level (LHRH-A: P < 0.01, DES-DP: P < 0.05). LHRH-A and DES-DP diminished serum FSH to 20% of the pre-treatment level (P < 0.005) and to an undetectable level (P < 0.001), respectively. LHRH-A and DES-DP decreased serum T to the castration level and an undetectable level, respectively (P < 0.001). Serum levels of the same 3 hormones before and after DES-DP administration were measured in 8 patients who received DES-DP after LHRH-A treatment or castration because of relapse of the disease. DES-DP lowered serum FSH further than LHRH-A to an undetectable level (P < 0.005) and diminished T further than previous treatments to an undetectable level (P < 0.05 vs. LHRH-A, P < 0.01 vs. castration). These results suggest that 1) DES-DP is able to reduce T production from extra-testicular site(s), and achieve the minimal serum T level, and 2) this DES-DP action appears to be one of the mechanisms of the effectiveness of the estrogen on refractory prostate cancer after castration or LHRH-A. In addition, basal (independent of LH-RH) FSH secretion in elderly men is about 20% of total FSH secretion and DES-DP inhibits the basal FSH secretion at the level of the pituitary.
Kitahara
S
S
Department of Urology, Tokyo Medical and Dental University School of Medicine, Japan.
Yoshida
K
K
Ishizaka
K
K
Kageyama
Y
Y
Kawakami
S
S
Tsujii
T
T
Oshima
H
H
D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D004054:Diethylstilbestrol / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005640:Follicle Stimulating Hormone / Q000097:blood*; D006801:Humans; D016729:Leuprolide / Q000627:therapeutic use*; D008297:Male; D009919:Orchiectomy; D011471:Prostatic Neoplasms / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D011966:Receptors, LHRH / Q000819:agonists*; D012189:Retrospective Studies; D013739:Testosterone / Q000097:blood*
D000970:Antineoplastic Agents; D011966:Receptors, LHRH; D013739:Testosterone; D004054:Diethylstilbestrol; D005640:Follicle Stimulating Hormone; C004955:fosfestrol; D016729:Leuprolide