Endocrine findings during hormonal treatment of metastasizing prostatic carcinoma

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Endocrine findings of hypophyseal, testicular and adrenal function in the hormonal treatment of advanced prostatic carcinoma are described. Diethylstilbestrol (DES) reduces significantly the plasma levels of testosterone, follicle-stimulating hormone (FSH) and luteinizing hormone (LH). In contrast, those of prolactin, dehydoepiandrosterone (DHEA), and cortisol as well as sexual hormone binding globulin (SHBG) are elevated. The additional administration of bromocriptine decreases prolactin to normal levels and further decreases the testosterone levels. The adrenal steroids are influenced differently: DHEA decreases as compared to the DES-treated group, while the cortisol levels rise significantly. The addition of cyproterone acetate to the therapeutic regimen decreases the cortisol levels, and all other values, including SHBG, are not altered significantly compared to the group treated with DES plus bromocriptine. What is of interest is that the estradiol levels are not altered by any treatment schedule. In a group of patients, orchiectomized prior to our study, the endocrine values are compared to those mentioned above. Following orchiectomy FSH and LH levels rise significantly, but not prolactin and SHBG. The testosterone levels were as low as under treatment with DES. From our results it is concluded that the combination of DES plus bromocriptine plus cyproterone acetate best achieves the inhibition of androgenic influence onto the prostatic carcinoma.