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Related Experiment Videos

Oestrogen dosage in prostatic cancer: the threshold effect?

M C Bishop1, R J Lemberger, C Selby

  • 1Department of Urology, City Hospital, Nottingham.

British Journal of Urology
|September 1, 1989
PubMed
Summary

Estradurin (polyoestradiol phosphate) showed initial effectiveness in advanced prostate cancer, similar to orchiectomy. Lower doses may reduce testosterone and minimize complications, suggesting a qualitative response to androgen withdrawal.

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Area of Science:

  • Oncology
  • Endocrinology
  • Urology

Background:

  • Advanced prostate carcinoma requires effective hormone therapy.
  • Estradurin (polyoestradiol phosphate) is a long-acting estrogen preparation.
  • Bilateral orchiectomy is a standard treatment for advanced prostate cancer.

Purpose of the Study:

  • To compare the efficacy of a lower dose of Estradurin with bilateral orchiectomy in advanced prostate carcinoma.
  • To investigate the relationship between plasma testosterone levels and treatment response.
  • To evaluate the potential for reduced estrogen dosage and associated risks.

Main Methods:

  • Prospective randomized trial comparing Estradurin (160 mg/month) with bilateral orchiectomy.
  • Monitoring of serial plasma testosterone levels.

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  • Assessment of clinical and biochemical responses.

    • Main Results:

    • Estradurin demonstrated initial clinical and biochemical responses comparable to orchiectomy.
    • Some patients experienced relapse in hormone sensitivity despite estrogen treatment.
    • Many patients with poorly suppressed testosterone responded to secondary orchiectomy.
    • Lower estrogen doses may be effective and minimize thrombo-embolic risks.

    Conclusions:

    • Response to androgen withdrawal in hormone-sensitive prostate cancer may be qualitative, not solely quantitative.
    • Reduced plasma testosterone levels, potentially midway between castrate and normal ranges, might be sufficient.
    • Lower effective doses of Estradurin could minimize side effects like thrombo-embolic complications.