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Effects of oestrogen therapy and orchidectomy on coagulation and prostanoid synthesis in patients with prostatic cancer

Medical Oncology and Tumor Pharmacotherapy volume 6, Article number: 219 (1989) Cite this article

Abstract

Twenty patients with prostatic carcinoma were randomized to therapy with either oestrogens (n =10) or orchidectonty (n =10). Activators and inhibitors of coagulation were studied before treatment, 1.5 months and 6 months after the start of treatment. We found that the patients in the oestrogen group had already increased their factor VII level after 1.5 months (P <0.001) and this increased level persisted after 6 months. Factor X tended to increase after 1.5 months and this increase reached significance after 6 months (P <0.01). In the orchidectomy groups there was a significant increase in factor X at 6 months (P <0.01) and, in addition, antithrombin III (AT III) was increased at this time. Furthermore, there was a parallelism between the increase in factor VII and electrocardiographic evidence of increased coronary insufficiency (r =0.60;P <0.025;n =15). We found a significant increase of thromboxane as evidenced by the major urinary metabolite 2,3-dinorthromboxane B 2 in the oestrogen group as compared to the orchidectomy group.

In summary, patients with prostatic cancer during long-term oestrogen treatment were found to have increased levels of factor VII, factor VIII:C and fibrinogen. In addition these patients showed increased formation of thromboxane. The changes imply a hypercoaguable state and platelet activation. No such signs were found after orchidectomy. The findings in the oestrogen group might explain the continuously increased risk of cardiovascular complications during long-term oestrogen therapy.

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Affiliations

  1. Dept of Medicine, Huddinge Hospital, S-141 86, Huddinge, Sweden

    P. Henriksson, G. Bratt, O. Edhag & O. Vesterqvist

  2. Dept of Clinical Chemistry and Blood Coagulation, Karolinska Hospital, S-104 01, Stockholm, Sweden

    M. Blombäck

  3. Dept of Urology, Huddinge Hospital, S-141 86, Huddinge, Sweden

    A. Eriksson

Authors
  1. P. Henriksson
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  2. M. Blombäck
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  3. G. Bratt
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  4. O. Edhag
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  5. A. Eriksson
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  6. O. Vesterqvist
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Henriksson, P., Blombäck, M., Bratt, G. et al. Effects of oestrogen therapy and orchidectomy on coagulation and prostanoid synthesis in patients with prostatic cancer. Med. Oncol. & Tumor Pharmacother. 6, 219 (1989). https://doi.org/10.1007/BF02985194

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  • DOI: https://doi.org/10.1007/BF02985194

Key words

  • Prostatic carcinoma
  • Oestrogen
  • Orchidectomy
  • Coagulation
  • Fibrinolysis
  • Thromboxane
  • Prostacyclin
  • Coronary insufficiency
  • Long-term effects