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Androgen effect on prostate specific antigen secretion.
1Department of Surgery, Fairfax Hospital, Falls Church, Virginia.
Journal of Surgical Oncology
|March 1, 1992
Summary
Androgen therapy can increase prostate-specific antigen (PSA) levels, even in patients without prostate cancer. Discontinuing and resuming androgen treatment confirmed its regulatory effect on PSA secretion.
Area of Science:
- Endocrinology
- Oncology
- Urology
Background:
- Diethylstilbestrol (DES) is a synthetic estrogen previously used for various medical conditions.
- Prolonged androgen therapy can influence prostate health and prostate-specific antigen (PSA) levels.
Observation:
- A patient treated with diethylstilbestrol (DES) for 9 years received parenteral androgen therapy for 1 year.
- The patient exhibited hypersecretion of prostate-specific antigen (PSA) without clinical evidence of prostate carcinoma.
Findings:
- PSA levels normalized upon temporary discontinuation of androgen therapy.
- PSA levels increased again upon resumption of androgen treatment, indicating a regulatory effect.
- Estrogen-suppressed prostatic cells responded to androgen stimulation with increased PSA secretion and positive immunohistochemical staining.
Implications:
- This case confirms the regulatory role of androgens in PSA secretion.
- Suggests a potential for "rebound" PSA elevation in patients undergoing androgen deprivation and subsequent testosterone replacement therapy.
- Highlights the importance of monitoring PSA levels during androgen therapy, particularly in patients with a history of estrogen exposure.