title: Dramatic decline in prostate-specific antigen by withdrawal of estramustine phosphate in hormone refractory prostate cancer.
abstract: Prostate-specific antigen (PSA) decline after discontinuation of estramustine phosphate (EMP) is extremely rare. We report a case with dramatic PSA decline after withdrawal of EMP. A patient with prostate cancer had been treated with luteinizing hormone-releasing hormone and EMP. After refractory, EMP was withdrawn. After withdrawal of EMP, PSA dramatically decreased from 214 ng/mL to 3.71 ng/mL (98.5% decline) and remained low for more than 17 months. In association with PSA decline, lumbago and metastatic lesions improved. We should be aware of this phenomenon and the discontinuation of EMP is recommended in patients with rising PSA after an initial response to EMP.
authors.affiliation: Division of Urology, Moji Rousai Hospital, Kitakyushu, Japan.
authors.forename: Mizuki
authors.initials: M
authors.lastname: Kobayashi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kuramoto
authors.forename: Junichiro
authors.initials: J
authors.lastname: Ota
authors.forename: Naohiro
authors.initials: N
authors.lastname: Fujimoto
mesh_terms: D000369:Aged, 80 and over; D018931:Antineoplastic Agents, Hormonal; D014408:Biomarkers, Tumor / Q000097:blood*; D018450:Disease Progression; D019008:Drug Resistance, Neoplasm; D004961:Estramustine / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood* / Q000188:drug therapy; D016312:Treatment Refusal
chemical_list: D018931:Antineoplastic Agents, Hormonal; D014408:Biomarkers, Tumor; D004961:Estramustine; D017430:Prostate-Specific Antigen