Androgen suppression by hydrocortisone without aminoglutethimide in orchiectomised men with prostatic cancer

The effects of hydrocortisone (HC) alone and in combination with aminoglutethimide (AG) have been studied on circulating blood levels of androgens in orchiectomised men with metastatic prostatic cancer. Serum testosterone levels were significantly lower in both early and late hydrocortisone-treated patients compared with pre-treatment levels. The regimen of HC + AG increased serum testosterone almost back to pre-treatment levels. Similar observations were noted with serum androstenedione, dehydroepiandrosterone sulphate and sex hormone binding globulin (SHBG) levels. Clinical responses to hydrocortisone alone have been observed in this series of patients. It is concluded that aminoglutethimide has no place in the therapy of prostatic cancer and that physiological doses of hydrocortisone represent the best second hormonal manoeuvre for prostatic cancer patients.