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Updated: Jul 5, 2026
Murine Prostate Micro-dissection and Surgical Castration
Published on: May 11, 2016
Morphological changes induced by androgen blockade in normal prostate and prostatic carcinoma
1Department of Pathology, Centre Hospitalier Universitaire de Québec, l'Hôtel-Dieu de Québec, Québec, Canada. bernard.tetu@chuq.qc.ca
Abstract:
Maximal androgen blockade (MAB), combining a luteinizing hormone releasing hormone (LHRH) agonist and a pure or non-steroidal anti-androgen, induces significant morphologic changes in the prostate. The tumor volume, density, capsular penetration, and surgical margin involvement are strongly reduced following such treatment. On histology, normal prostate tissue and tumor undergo marked atrophy and shrinkage. Although residual cancer cells are readily identifiable in most cases, they may often be sparse and easily overlooked. The increased Gleason score apparent after MAB is most likely related to fragmentation of acinar structures, and grading is not recommended following MAB. Residual cancer cells show features of lower activity and increased apoptosis. Such therapy-induced changes may be reversible, although occasional clones of cancer cells are apparently not affected and have probably developed resistance. Finally, MAB leads to marked but reversible morphologic changes and reduction in prevalence and extent of prostatic intra-epithelial neoplasia (PIN). Monotherapy using a variety of agents causes comparable but often less extensive changes.
Insights
Maximal androgen blockade (MAB) significantly shrinks prostate tumors and normal tissue, reducing cancer spread. While cancer cells may become sparse, MAB-induced changes are largely reversible.
Area of Science:
- Urology
- Oncology
- Pathology
Background:
- Maximal androgen blockade (MAB) involves LHRH agonists and anti-androgens.
- MAB is known to induce significant morphologic changes in prostate tissue.
Purpose of the Study:
- To detail the morphologic changes in prostate cancer and normal tissue following MAB.
- To assess the impact of MAB on tumor characteristics and prostatic intraepithelial neoplasia (PIN).
Main Methods:
- Histological examination of prostate tissue after MAB treatment.
- Evaluation of tumor volume, density, capsular penetration, and surgical margins.
Main Results:
- MAB significantly reduces tumor volume, density, capsular penetration, and surgical margin involvement.
- Histology shows marked atrophy and shrinkage of normal and tumor prostate tissue; residual cancer cells can be sparse.
- MAB causes reversible changes in morphology and reduces PIN prevalence and extent.
Conclusions:
- MAB induces substantial, largely reversible, morphologic changes in the prostate, impacting tumor characteristics.
- Therapy-induced changes may obscure cancer cell identification and affect Gleason scoring; resistance can develop.
- MAB effectively reduces tumor burden and PIN, though monotherapy may yield comparable effects.
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