[Endocrine treatment of prostatic cancer. A renaissance for parenteral estrogen]

The standard treatment for advanced cases of cancer of the prostate is castration. Oestrogens, administered per os may have serious side effects, in particular thrombosis and cardiovascular complications. If the oestrogens are administered parenterally, changes in liver function can be avoided and risk of side effects markedly reduced. 38 patients have been treated at Huddinge Hospital in Stockholm, and 14 patients at Aker Hospital in Oslo, with polyoestradiol phosphate (Estradurin) 240 mg injected intramuscularly every 4th week (initial dose 320 mg). We can sum up our own experience as follows: Plasma testosterone is reduced to castration level after 2-3 weeks. Liver function, evaluated by the sexual hormone binding globulin level in plasma, remains unchanged. Morbidity and mortality from cancer are the same as may be achieved by surgical orchidectomy. The only side effect of significance is gynaecomastia. Follow-up of the patients does not indicate any increased risk of thrombosis or cardiovascular disease. The treatment is fairly cheap compared with other alternative methods of endocrine treatment.