Partial androgen suppression consequent to increased secretion of adrenal androgens in a patient with prostate cancer treated with long-acting GnRH agonists.
We present a case report of a patient with prostate cancer who failed to demonstrate consistent testosterone suppression to castration levels and incomplete suppression of serum prostate-specific antigen, although treated with gonadotropin releasing hormone agonists for 48 months. Serum dehydroepiandrosterone, dehydroepiandrosterone sulphate, as well as the androgen metabolite, androsterone glucuronide, were elevated compared to the other patients. The present data suggest that those prostate cancer patients who have even marginally elevated adrenal androgens may especially benefit from combined androgen blockade.
Institute of Hormone Research, Shaare Zedek Medical Center, Faculty of Medicine, Hebrew University, Jerusalem, Israel.
I M
IM
Spitz
B
B
Chertin
A
A
Fridmans
A
A
Farkas
A
A
Belanger
H
H
Hartman
F
F
Labrie
D000230:Adenocarcinoma / Q000097:blood* / Q000188:drug therapy*; D000368:Aged; D000726:Androgen Antagonists / Q000627:therapeutic use; D000728:Androgens / Q000097:blood*; D000813:Anilides / Q000627:therapeutic use; D002064:Buserelin / Q000627:therapeutic use; D003967:Diarrhea / Q000139:chemically induced; D005485:Flutamide / Q000627:therapeutic use; D005743:Gastrectomy; D005901:Glaucoma / Q000150:complications; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists* / Q000031:analogs & derivatives / Q000627:therapeutic use; D006551:Hernia, Hiatal / Q000150:complications; D006801:Humans; D007986:Luteinizing Hormone / Q000097:blood; D008297:Male; D009570:Nitriles / Q000627:therapeutic use; D010437:Peptic Ulcer / Q000150:complications / Q000601:surgery; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood* / Q000188:drug therapy*; D013739:Testosterone / Q000097:blood; D014105:Tosyl Compounds / Q000627:therapeutic use
D000726:Androgen Antagonists; D000728:Androgens; D000813:Anilides; D009570:Nitriles; D014105:Tosyl Compounds; D007987:Gonadotropin-Releasing Hormone; D013739:Testosterone; D005485:Flutamide; D007986:Luteinizing Hormone; C053541:bicalutamide; D017430:Prostate-Specific Antigen; C029256:histrelin; D002064:Buserelin