Surgical Castration in Hormone-Refractory Metastatic Prostate Cancer Patients Can Be an Alternative for Medical Castration. (15th June 2011)

• Record Type: Journal Article
• Authors: Zaitsu, Masayoshi; Yamanoi, Mariko; Mikami, Koji; Takeshima, Yuta; Okamoto, Naohiko; Imao, Sadao; Tonooka, Akiko; Takeuchi, Takumi
• Other Names: Burger Maximilian Academic Editor.
• Is Part Of: Advances in urology. Volume 2012(2012)
• Publication Date: 2011-06-15
• Subjects: Urology -- Periodicals; 616.6005
• DOI: 10.1155/2012/979154
• Languages: English
• ISSNs: 1687-6369

Abstract

Abstract : Background . Most patients with metastatic prostate cancer are endocrinologically treated with LHRH agonist, but finally castration-refractory and hormone-refractory cancers occur. Serum testosterone levels get low to "the castration level" by LHRH agonists but may not get low enough against castration-refractory prostate cancer. Methods . As case series, twelve patients suffering from hormone-refractory prostate cancer continuously on LHRH agonist underwent surgical castration. Additionally, one hundred and thirty-nine prostate cancer patients on LHRH agonist or surgical castration were tested for serum total testosterone levels. Results . Surgical castration caused decrease in serum PSA in one out of 12 hormone-refractory prostate cancer patients with PSA reduction rate 74%. Serum total testosterone levels were below the sensitivity threshold (0.05 ng/mL) in 40 of 89 (44.9%) medically castrated patients and 33 of 50 (66.0%) surgically castrated patients (P = .20 ). Conclusion . Even hormone-refractory prostate cancer patients are candidates for surgical castration because of endocrinological, oncological, and economical reasons.