20. Percutaneous 17β-estradiol in the treatment of prostatic cancer

xiv

Abstracts

ever a remission of the tumour growth did not occur. Different contents of receptor proteins in the various differentiated types of prostatic cancer cells may explain the different response of the tumours to the endocrine theraPY. Erieg et al. (1) demonstrated e.g. a higher receptor protein content in cribriform Tartrate-inhibitedacid phosphatase has been and poorly differentiated compared to well isolated from human prostatic tissue and a specific antiserum obtained following iusauni- differentiated tumours. Endocrine treatment is very effective in zation of rabbits. A double antibody radioprostatic cancer but its definite role still immunoassay has been designed which employs remains open. Further studies are necessary the primary antiserum in a final dilution of to compare endocrine with other treatment 1:100,000 and uses a second antibody covaforms e.g. radio- and chemotherapy. lently coupled to a solid carrier. An assay can be ccmpleted in only 24 h. Reference The assay appears to be specific for pro1. Erieg M., Grobe I., Voigt K.D., Alten&hr static acid phosphatase {PAP). Sera from E. and Xlosterhalfen H.: Human prostatic women and healthy men did not contain signifcarcinoma: significant differences in its icant amounts of irnmunoreactive PAP. In a androgen binding and metabolism compared double-blind study including 30 patients to the human benign prostatic hypertrophy. treated for prostatic cancer in various Acta endocr., Kbh. 88 (19781 397-407. stages, elevated values were found in 53%. Only 2 patients (6%) were detected with the standard enzymatic method. Significant blood 20. Percutaneous 178-estradiolin the treatlevels of PAP were found in 25% of patients ment of prostatic cancer, A. STEG, G. with stage 1 carcinoma and in 50% of those BENOIT and A. LIMOUZIN-LAMGTTE,Clinique with stage 2. 27 patients with testicular Urologique de L'Hdpital Cochin, 27 Rue du cancer showed normal values. Faubourg St Jaques, 75014 Paris These preliminary results indicate that the radioimmunoassayof prostatic acid phosA natural estrogen, 17$-estradiolwas given phatase in serum represents a significant percutaneouslyat a dose of 600 ug/day to 21 improvement in the diagnosis of prostatic patients with untreated prostatic Cancer. cancer. The follow-up lasted 1 year, and there were no ischaemic or embolic complications. The follow-up at 3 months demonstrated 19. Endocrine treatment of prostatic disease, satisfactory plasma concentration of the esH. BBCKER, Clinic of Urology, University trogen, a drop in plasma testosterone to 1 of Hamburg, Germany ng/ml, (the same levels as with 3 mg of diethyl stilboestrol) and a decrease in hypeThe observation that prostatic glands are physeal secretion as shown by lower FSH and stimulated by androgens and that withdrawal m levels. of these hormones causes atrophy of the prosTriglycerides,and VLDL (very low density tate led to the introduction of endocrine lipoproteins)considered to be good indicatreatment in prostatic cancer. Hugqins and tors of cardiovascularrisk were statisticalHodges were the first to parform this type of ly unchanged. treatment in 1941 and the principle of this This preliminary study prompted us to comtherapy has been retained to the present in pare the effects of percutaneous natural esseveral variations. Bilateral orchidectomy trogens versus oral synthetic estrogens is the surest way to reduce the testosterone which, as shown by the Veterans Administralevels in serum without severe side effects. tions Coopexative Group may cause ischaemic Estrogen treatment has the same effect, but and embolic complications. high doses favour cardiovasculardiseases, as could be demonstrated by the Vacurq study. Antiandrogens act on the peripheral cell and have also been introduced - mainly as cyproterone acetate - for the therapy of prostatic OVARIAN FUNCTION AND DISEASE cancer. All these various treatments do not totally remove the androqens from the serum, 21. Normal ovarian function, G-T. ROSS, Testosterone levels between 0.3 and 0.6 ugfl The Clinical Center, National Institutes correspond well with levels found in women. of Health, Public Health Service, DepartAdrenalectomy and corticosteroid therapy may lead to a further reduction in serum androment of Health, Education, and Welfare, U.S.A. Pituitary ablation has thesameeffect. gem. It has been suggested that prolactin acts synergisticallywith testosteroneat the celGametogenesis- the production of an ovum -, lular level in the prostate. Therefore antiand steroidoganesis- the production of sufprolactin therapy with lisuride hydrogen ficient sex steroid hormones to insure inimaleate was performed in patients with protiation and early maintenance of pregnancy, static cancer and increased prolactin levels, should fertilizationoccur - are the results where a tumour progression after a time of of normal cyclic ovarian function. In a remission was present. This drug led to a spontaneous ovulatory menstrual cycle in a decrease of the prolactin serum levels, hownormal woman, ovulation oqxrs in only one of 18. Diagnosis of proState cX%Xer using a radioimmunoassayfor prostatic acid phosphatase in serum, O.A. LEA and P.A. H~ISAETER, Hormone Laboratory and Department of Surgery, University of Bergen, Norway