title: Comparable amounts of sex steroids are made outside the gonads in men and women: strong lesson for hormone therapy of prostate and breast cancer.
abstract: The objective of this study was comparison of circulating androgens and their metabolites as well as estrogens measured for the first time by a validated mass spectrometry technology in 60-80-year-old men and women of comparable age. Castration in men (n=34) reduces the total androgen pool by only about 60% as indicated by the decrease in the serum levels of the glucuronide metabolites of androgens compared to intact men (n=1302). Such data are in agreement with the 50 to 75% decrease in intraprostatic dihydrotestosterone (DHT) concentration after castration. Most interestingly, the same amounts of androgens and estrogens are found in postmenopausal women (n=369) and castrated men of comparable age. The most significant therapeutic implication of these findings is the absolute need to add a pure (nonsteroidal) antiandrogen to castration in men with prostate cancer in order to block the action of the 25 to 50% DHT left in the prostate after castration. Not adding an antiandrogen to castration in men treated for prostate cancer is equivalent to not prescribing a blocker of estrogens in women suffering from breast cancer because they are postmenopausal and have low circulating estradiol.
authors.affiliation: Molecular Endocrinology and Oncology Research Center, Laval University Hospital Research Center (CRCHUL) 2705, Laurier Boulevard, Quebec City, Quebec, Canada G1V 4G2. fernand.labrie@crchul.ulaval.ca
authors.forename: Fernand
authors.initials: F
authors.lastname: Labrie
authors.forename: Leonello
authors.initials: L
authors.lastname: Cusan
authors.forename: José Luis
authors.initials: JL
authors.lastname: Gomez
authors.forename: Céline
authors.initials: C
authors.lastname: Martel
authors.forename: René
authors.initials: R
authors.lastname: Bérubé
authors.forename: Patrick
authors.initials: P
authors.lastname: Bélanger
authors.forename: Alain
authors.initials: A
authors.lastname: Bélanger
authors.forename: Liesbeth
authors.initials: L
authors.lastname: Vandenput
authors.forename: Dan
authors.initials: D
authors.lastname: Mellström
authors.forename: Claes
authors.initials: C
authors.lastname: Ohlsson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000097:blood / Q000188:drug therapy*; D002369:Castration; D005260:Female; D008401:Gas Chromatography-Mass Spectrometry; D012739:Gonadal Steroid Hormones / Q000096:biosynthesis* / Q000097:blood / Q000627:therapeutic use*; D006066:Gonads / Q000378:metabolism*; D020249:Hormone Replacement Therapy; D006801:Humans; D008297:Male; D008954:Models, Biological; D017698:Postmenopause / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000188:drug therapy*; D012727:Sex Characteristics
chemical_list: D012739:Gonadal Steroid Hormones