Testosterone and 4-androstenedione concentration in peripheral and spermatic venous blood of patients with prostatic adenocarcinoma: Effects of diethylstilbestrol and cyproterone acetate therapy

Abstract

The present investigation has been carried out in 19 patients affected by prostatic adenocarcinoma, in an effort to obtain further information on the mechanism of action of diethylstilbestrol and cyproterone acetate on the testicular androgen function. Testosterone and 4-androstenedione concentrations were determined in peripheral and spermatic venous blood, obtained simultaneously at the time of orchiectomy. The pre-treatment mean peripheral plasma levels of testosterone were within the normal range (0.446 ± 0.157 μg/100 ml) while 4-androstenedione was slightly increased (0.169 ± 0.088 μgl/100 ml). Comparatively the values in spermatic venous blood were 9.792 ± 5.046 μg/100 ml for testosterone and 0.854 ± 0.296 μg/100 ml for 4-androstenedione. After diethylstilbestrol treatment peripheral and spermatic testosterone levels decreased to 0.128 ± 0.070 μg/100 ml and to 0.915 ± 0.766 μg/100 ml respectively, whereas no significant variations were registered for 4-androstenedione. Similar results were obtained with cyproterone acetate: reduction of testosterone concentrations (0.177 ± 0.079 μg/100 ml in peripheral blood, 1.800 ± 1.064 μg/100 ml in spermatic vein) and no significant variations for 4-androstenedione. atic vein) and no significant variations for 4-androstenedione. In conclusion these data demonstrate that diethylstilbestrol and cyproterone acetate express their antiandrogenic effects on the testicular function, inhibiting mainly the secretion of testosterone, which is one of the most important hormonal factors in the growth of prostatic adenocarcinoma.