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Androgen effect on prostate specific antigen secretion.

K A Hanash1, K F Mostofi

  • 1Department of Surgery, Fairfax Hospital, Falls Church, Virginia.

Journal of Surgical Oncology
|March 1, 1992
PubMed
Summary
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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.

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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.