Possible bone-preserving capacity of high-dose intramuscular depot estrogen as compared to orchidectomy in the treatment of patients with prostatic carcinoma

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 mar...

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Bibliographic Details
Published in:The Prostate 1997-05, Vol.31 (3), p.193-197
Main Authors: Carlström, Kjell, Stege, Reinhard, Henriksson, Peter, Grande, Mirtha, Gunnarsson, Per Olov, Pousette, Åke
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Biological and medical sciences
Biomarkers - blood
Bone and Bones - drug effects
Bone and Bones - metabolism
bone mineral
Carcinoma - blood
Carcinoma - therapy
cardiovascular effects
Collagen - metabolism
Delayed-Action Preparations
Estradiol - administration & dosage
Estradiol - analogs & derivatives
Estradiol - therapeutic use
Estradiol Congeners - administration & dosage
Estradiol Congeners - therapeutic use
estrogen treatment
Humans
Injections, Intramuscular
Male
Medical sciences
Middle Aged
Nephrology. Urinary tract diseases
orchidectomy
Orchiectomy
prostatic cancer
Prostatic Neoplasms - blood
Prostatic Neoplasms - therapy
Testosterone - blood
Tumors of the urinary system
Urinary tract. Prostate gland
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Summary: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 caner. Prostate 31:193–197, 1997. © 1997 Wiley‐Liss, Inc.
ISSN:0270-4137
1097-0045
DOI:10.1002/(SICI)1097-0045(19970515)31:3<193::AID-PROS8>3.0.CO;2-M