Transdermal oestrogen therapy as a second-line hormonal intervention in prostate cancer: a bad experience.
OBJECTIVE
To compare transdermal oestrogen with oral diethylstilbestrol (DES) as a second- or third-line hormonal therapy in the treatment of prostate cancer.


METHODS
In all, 32 assessable patients who, having already had a relapse on at least one line of hormonal therapy, received transdermal oestrogen therapy as an alternative to oral DES, when DES became unavailable.


RESULTS
Whereas DES had controlled the prostate-specific antigen (PSA) level for a median of 29 weeks in a group of 15 patients in remission, all but one had an increase in PSA level (median 86% increase above the starting PSA level) within a median of 8 weeks after introducing transdermal therapy. This increase was reversed in seven of the 12 patients who recommenced DES therapy.


CONCLUSIONS
Although the use of transdermal oestrogen is currently attracting enthusiasm as a first-line treatment for prostate cancer, these results show that for second- or third-line therapy further cautious research with careful monitoring is necessary.
Kandola
Sandhir
S
Oncology Department, University College Hospital, London, UK.
Anyamene
Nicola
N
Payne
Heather
H
Harland
Stephen
S
D000279:Administration, Cutaneous; D018931:Antineoplastic Agents, Hormonal / Q000008:administration & dosage*; D004958:Estradiol / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000097:blood / Q000188:drug therapy; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood / Q000188:drug therapy*; D012189:Retrospective Studies; D017211:Treatment Failure
D018931:Antineoplastic Agents, Hormonal; D004958:Estradiol; D017430:Prostate-Specific Antigen