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Query: UMLS:C0376358 (prostate cancer)
 59,338 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The effect of oestrogen (diethylstilboesterol diphosphate, DES-P) on immunity to tumour-associated antigens in patients with prostatic cancer was evaluated by leucocyte adherence inhibition, a suggested in vitro correlate of cellular immunity. Significant (P smaller than 0.05) suppression of immunity to malignant prostate was observed in thirty out of thirty-one patients following pre-incubation of their leucocytes with therapeutically significant levels of DES-P. Suppression of tumour-associated immunity by exogenous oestrogen provides further evidence to earlier studies demonstrating oestrogenic suppression of non-specific cellular responsiveness evaluated by mitogen-induced lymphocytic blastogenesis, and for concern over the efficacy of oestrogenic therapy and its adverse effect in the treatment of patients with hormone-dependent tumours and responsive diseases. The reduced efficiency of immunosurveillance of tumours and underlying infectious agents may contribute to the exacerbation of disease. While speculative, these observations may also be relevant to the possible assocition between uterine cancer and prolonged administration of DES and the development of vaginal tumours in offspring found in association with maternal ingestion during pregnancy.
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PMID:Modulatory effects of oestrogen on immunological responsiveness. II. Suppression of tumour-associated immunity in patients with prostatic cancer. 9 29

Cholesterol and triglycerides were measured in plasma samples from patient with cancer of the prostate before and after 3 months treatment with either Premarin, Provera, Provera and diethylstilbestrol, or diethylstilbestrol alone. Cholesterol was also measured before and after one of three doses of diethylstilbestrol or placebo. Pretreatment cholesterol levels at 196 +/- 1.3 mg per 100 ml (X +/- SE, N = 1093) were significantly lower than these reported for similar age group noncancer controls. Significant increases occurred with some of the estrogen treatments. Pretreatment cholesterol levels showed a significant negative correlation with age in Stage III and IV patients of both studies and a positive correlation with hemoglobin in Stage III patients of both studies. Pretreatment triglyceride levels at 120 +/- 1.9 mg per 100 ml (X +/- SE, N = 1089) were similar to levels reported for noncancer controls of similar age. Estrogen treatment produced a significant increase in triglyceride levels. Serum triglycerides were significantly correlated with hemoglobin, weight, and cholesterol and negatively correlated with age, Analysis of covariance for both cholesterol and triglycerides showed highly significant treatment effects, but no stage effects and no stage-treatment interactions. It showed that the pretreatment value is of extreme importance for predicting or explaining the 3-month value. Death rates were calculated by level of pretreatment cholesterol or pretreatment triglycerides for all Stage II and IV patients, all treatments combined, and for Study 2 and Study 3 separately. No consistent trends were evident for cholesterol. Spearman correlation coefficients between category of initial triglyceride value and rank of death rate were computed to test for a quadratic effect. When the absolute values of the initial triglyceride values minus the overall mean were correlated with the death rate, a significant negative correlation was found for all causes of death and for deaths due to cardiovascular disease and prostatic cancer. These results indicate that the death rate is highest near the overal mean for initial triglyceride values and decreases as the initial values deviate above or below the mean. Initial triglyceride levels appear to have potential as indicators of risk of death in patients with prostatic cancer. The percentage of patients dead at 1 year by initial triglyceride levels, measured only in Study 3, revealed a pattern similar to that observed for the death rate, that is, the highest percentages were associated with values near the overall mean.
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PMID:Response of serum cholesterol and triglycerides to hormone treatment and the relation of pretreatment values to mortality in patients with prostatic cancer. 18 47

The Department of National Health and Welfare's special advisory committee are closely monitoring women, who used DES(diethylstilbestrol) for protection of pregnancy, and their offspring. DES daughters have an increased risk of benign abnormalities of the genital tract and, infrequently, vaginal or cervical cancer. Prenatal exposure of males to DES have shown a low frequency of epidiymal cysts, hypoplastic testes, induration of the testicular capsule, and impairment of spermatogenesis, sperm maturation, and accessory gland secretion. Women who used DES during their pregnancy may possibly have an increased risk of breast cancer although the incidence is not statistically significant. The advisory committee recommends that DES and other estrogenic drugs not be used during pregnancy for treatment of threatened abortion due to the possible abnormalities of the fetus. Instead the committee suggests that DES be used for patients with estrogen-responsive metastatic breast cancer or advanced prostate cancer.
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PMID:Diethylstilbestrol: risks of malignant disease and congenital malformations. 45 96

Open perineal cryosurgical prostatectomy has been reported previously in 154 consecutive prostatic cancer patients at our center. In 37 of these patients post-cryosurgery biopsies of the prostate were obtained. In the present report we compare this tissue to the preoperative biopsies. The data suggest that well differentiated cancers are associated with advantageous survival in cryosurgery patients. Lymphoid and eosinophilic cell infiltrates may represent post-cryosurgical local immune responses, with improved survival. Estrogen therapy seems to suppress this local immune response. One month or more after cryosurgery cancer in the biopsy correlates with palpable local recurrence but prior to 1 month it does not correlate. Cryosurgery by the open perineal approach has been an effective method to eliminate the primary lesion in localized and extensive prostatic cancer.
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PMID:Biopsy and clinical course after cryosurgery for prostatic cancer. 68 48

A continuing education examination of estrogen therapy is discussed. The most common indication of estrogen therapy is for replacement in menopausal women. Estrogens can also be used in the treatment of certain types of cancer such as prostatic cancer. A diagnosis of estrogen deficiency must be established first and then estrogen therapy must be selectively used. Psychoemotional problems must be ruled out. Perimenopausal patients may be treated somewhat differently than postmenopausal patients. 1 of the major controversies surrounding estrogen therapy, other than cancer and osteoporosis, is its implication to coronary heart disease. The evidence indicates that estrogen in some way contributes to endometrial carcinoma. Estrogen administration does not seem to show a correlation to breast cancer. Actual treatment must be individualized, and which estrogen, how much, and how long it should be used is still not clear.
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PMID:Estrogen therapy. 70 1

150 cases of prostate cancer treated with estrogens at the Urology clinic of the Hotel-Dieu from 1963 to 1974 are presented. The men ranged in age from 50 to 91; the majority were 60-69 years. Their clinical stages were 29% Stage 1, no perceptible mass; 43% Stage 2, nodule felt on rectal exam; 13% Stage 3, tumor extended outside the prostate but not metastases, normal prostatic phosphatases; and 15% Stage 4, elevated prostatic phasphatases and metastases. Diagnosis was by urinary symptoms in Stage 2 or above, rectal palpation, and puncture biopsy under local anesthesia. Estrogen treatment consisted of diethylstilbestrol, stilbelstrol diphosphate or TACE (Chlorotraianisene), or estradiol. Estrogen side effects were loss of libido after 1 month, gynecomastia, and nausea. Other treatments included prostatectomy in Stages 1 and 2, cobalt in 5 cases, castration in 3 cases, 1 endo-uretral resection, and 1 hypophysectomy. 50% died in 1 year and 16% were lost to follow up and presumed dead in 1 year; the mean survival of the others was 3 years. Estrogen therapy improved symptoms and reversed tumor growth temporarily in hormone-dependent cancers, but these tumors all escape hormone control eventually.
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PMID:[Course of prostate cancer under estrogen therapy]. 87 31

A number of therapeutic agents including L-asparaginase, Actinomycin-D, CCNU, Hydroxyurea, 5-FU, Cis-platinum, Cyclophosphamide, orchiectomy, Adriamycin and DES alone and in various combinations has been applied against the Dunning R-3327 rat prostatic adenocarcinoma subline G. We have found a parallel between the results of this study and those of similar therapeutic application to the human tumor. We conclude that this animal model may prove to be a useful screening system for agents against human prostatic cancer.
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PMID:Chemotherapy of the transplantable adenocarcinoma (R-3327) of the Copenhagen rat. 91 40

The Veterans' Administration Cooperative Urological Research Group has conducted three consecutive randomized clinical trials of various treatments for all stages of prostatic carcinoma. Thus far, a total of 3774 patients have been entered into these three main studies. The first study showed that early endocrine treatment of patients with advanced prostatic cancer did not increase overall survival when compared to initial treatment with placebo alone. Diethylstilbestrol, when given in a dose of 5.0 mg/day, was associated with an increased incidence of cardiovascular deaths. In the second study, diethylstilbestrol given in a dose of 1.0 mg/day has been as effective as the 5.0-mg dose in controlling the prostatic carcinoma but has been associated with a lower incidence of cardiovascular deaths. Patients are still being entered into the third study and it is too early to report the findings in detail.
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PMID:The Veterans' Administration Cooperative Urological Research Group studies of carcinoma of the prostate: a review. 109 70

Prostate-specific antigen (PSA) has emerged as the most useful marker for management of patients with prostate cancer. The regulation of this glycoprotein in vivo has important clinical implications. Indirect evidence indicates that the PSA glycoprotein might be regulated by androgens, and previous studies in this laboratory have demonstrated that PSA mRNA is upregulated by androgens. The current work reports a detailed study of PSA glycoprotein expression as influenced by steroid hormones in a human prostatic adenocarcinoma cell line, LNCaP. First, we have examined the steroid binding specificity of the androgen receptor in this cell line. In comparison with wild-type rat androgen receptor in prostate, the receptor in LNCaP cells has altered affinity for a number of steroids or analogs such as progesterone (R5020), antiprogesterone (RU486), two antiandrogens (cyperoterone acetate and hydroxyflutamide), and an androgen metabolite (epitestosterone). However, its affinity for androgens (mibolerone, dihydrotestosterone, and testosterone) is not changed. The receptor does not bind to the synthetic glucocorticoids (triaminolone acetonide and dexamethasone) nor to a synthetic estrogen DES (diethylstilbestrol). The change of the steroid binding specificity of the receptor is correlated with a single mutation (A----G at nucleotide #876 relative to the initiation codon) of the steroid binding domain of the receptor. The mutation and alteration of steroid-binding specificity of the androgen receptor is also correlated with PSA glycoprotein expression affected by different ligands tested. We have demonstrated that the PSA glycoprotein is upregulated by androgens and is affected by neither epidermal growth factor nor basic fibroblast growth factor. Moreover, PSA glycoprotein could be induced by R5020, estradiol, and epitestosterone; but neither glucocorticoids nor DES had any effect on PSA induction. Interestingly, although the antiandrogen, cyperotone acetate, had the ability to induce PSA, both RU486 and hydroxyflutamide could block androgen and progesterone induction of PSA glycoprotein. Therefore, we conclude that the PSA glycoprotein expression is influenced predominantly by androgens via its receptor, and the mutation of the receptor can affect the expression of this cellular gene by the steroids other than androgens.
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PMID:Hormonal regulation of prostate-specific antigen (PSA) glycoprotein in the human prostatic adenocarcinoma cell line, LNCaP. 137 63

Fifteen years ago we embarked on a treatment protocol for prostatic cancer patients with widespread disease (Stage D2) which included both hormonotherapy (i.e., orchiectomy and diethylstilbestrol [DES] 5 mg/day--later substituted with cyproterone acetate [CPA] 0.2 g/day) and chemotherapy (cyclophosphamide and 5-fluorouracil 10 mg/kg/week). The rationale for such an approach was the universally poor results obtained from the conventional approach which advocated consecutive single-treatment schedules once the previous therapy had ceased to be effective. As such a conventional approach probably allowed the selection of new resistant cell clones, we assumed that perhaps an aggressive combined systemic therapeutic approach from the start, would give such a group of patients--already with generalized disease--a better long-term result. In retrospect, after fifteen years, the chemotherapy on a series of 50 patients so treated has been well tolerated with only minimal, temporary side effects. This regimen was continued up to five years with a reduced maintenance dose. The hormonotherapy was also well tolerated, and was fully maintained. Only 28 percent died of their disease (16% within the first 2 years); 28 percent died of other causes; 40 percent are still alive (14% with clinical disease). In only 9 cases was the chemotherapy discontinued for various reasons. No control arm was originally designed in this protocol, but the long-term results suggest that our original concept was probably valid. Further studies, with the possible use also of newer chemotherapeutic agents, may well justify considering this combined therapeutic approach when dealing with this disease in its widespread form.
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PMID:Fifteen years' experience of combined hormone/chemotherapy in metastatic prostate cancer. 153 3


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