Possible bone-preserving capacity of high-dose intramuscular depot estrogen as compared to orchidectomy in the treatment of patients with prostatic carcinoma
✍ Scribed by Carlström, Kjell; Stege, Reinhard; Henriksson, Peter; Grande, Mirtha; Gunnarsson, Per Olov; Pousette, Åke
- Publisher
- John Wiley and Sons
- Year
- 1997
- Tongue
- English
- Weight
- 809 KB
- Volume
- 31
- Category
- Article
- ISSN
- 0270-4137
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✦ Synopsis
Background:
Treatment of prostatic disease with gnrh agonists or by orchidectomy affects bone mass negatively. estrogen treatment has beneficial effects on bone mass in women and might hypothetically have a bone preserving capacity also in patients with prostatic cancer.
Methods:
We followed serum markers for bone and collagen metabolism and sex steroids for 18 months in patients with prostatic cancer treated by orchidectomy (n = 13) or by single-drug parenteral polyestradiol phosphate (240 mg intramuscularly every second week for the first two months, and then every fourth week; n = 17).
Results:
Total and free testosterone reached castration levels within 1.5 months of estrogen treatment. four patients developing progressive disease and/or signs of metastasis were excluded from the analysis. in the remaining patients, serum osteocalcin, procollagen iiip (piiinp), procollagen (picp), and the crosslinked carboxyterminal telopeptide of type i collagen (ictp) increased significantly over time following orchidectomy (n = 11). serum osteocalcin and picp decreased significantly over time during estrogen treatment (n = 15). treatment values of all four markers were significantly lower in estrogen-treated than in orchidectomized patients.
Conclusions:
The changes in serum bone and collagen markers indicate an increased bone turnover in orchidectomized subjects. the opposite pattern was found in the estrogen-treated patients, indicating a reduced turnover. estrogens may also have a bone mass-preserving capacity in elderly males with prostatic cancer.