Dramatic decline in prostate-specific antigen by withdrawal of estramustine phosphate in hormone refractory prostate cancer.
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 After refractory, EMP was withdrawn.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.
Kobayashi
Mizuki
M
Division of Urology, Moji Rousai Hospital, Kitakyushu, Japan.
Kuramoto
Hiroshi
H
Ota
Junichiro
J
Fujimoto
Naohiro
N
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
D018931:Antineoplastic Agents, Hormonal; D014408:Biomarkers, Tumor; D004961:Estramustine; D017430:Prostate-Specific Antigen