Estrogens in the Treatment of Prostatic Cancer

  • J. Altwein
Part of the NATO Advanced Science Institutes Series book series (NSSA, volume 53)


Treatment with estrogens is the most commonly used modality for the management of advanced prostatic carcinoma (PCA). Their major mode of action is thought to be by the suppression of Lutenising Hormone (LH) and Follicle Stimulating Hormone (FSH) release from the pituitary to control the output of testosterone (1). Only chloro-trianisene (Tace) does not exert an antigonadotrophic action. The decrease of plasma testosterone and testicular atrophy result primarily from the central gonadotrophin suppression; however, a direct inhibition of testosterone synthesis is also involved (2) (Table 1). There is evidence that estrogens inhibit the testicular
Table 1

Estrogen* Inhibition of Androgen Synthesis


Lowered Precursor


17.20 Desmolase



Samuels 1964 (48)

3β OH Steroid dehydrogenase


17α Progesterone Testosterone

Goldman 1968 (49)

Yanaihara (1972) (2)

17α Hydroylase

17α OH Pregnenolone

17α OH Progesterone

Samuels 1964 (48)

* Estradiol-17α and DES

Table 2

Testosterone Levels (ng/dl) in PCA After Treatment With Orchiectomy and Estrogens



DES (mg q.d.)





Young 1968 (50)




Robinson 1971 (4)





Mackler 1972 (51)






Kent 1973 (5)






Shearer 1973 (6)






3 β -hydroxysteroid dehydrogenase, thus blocking the degradation of pregnenolone, one step in the formation of testosterone in vivo (3). Since steroidogenesis inhibition requires a high dose of estrogen, this mechanism may only be operative with chlorotrianisene.


Prostatic Carcinoma Estrogen Treatment Plasma Testosterone Cyproterone Acetate Plasma Testosterone Level 
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Copyright information

© Springer Science+Business Media New York 1983

Authors and Affiliations

  • J. Altwein
    • 1
  1. 1.Bundeswehrkrankenhaus UlmUlmWest Germany

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