Transdermal oestrogen therapy as a second-line hormonal intervention in prostate cancer: a bad experience

Authors


Stephen J Harland, Department Oncology, UCH, 250 Euston Road, London NW1 2PG. e-mail: s.harland@ucl.ac.uk

Abstract

OBJECTIVE

To compare transdermal oestrogen with oral diethylstilbestrol (DES) as a second- or third-line hormonal therapy in the treatment of prostate cancer.

PATIENTS AND METHODS

In all, 32 assessable patients who, having already had a relapse on at least one line of hormonal therapy, received transdermal oestrogen therapy as an alternative to oral DES, when DES became unavailable.

RESULTS

Whereas DES had controlled the prostate-specific antigen (PSA) level for a median of 29 weeks in a group of 15 patients in remission, all but one had an increase in PSA level (median 86% increase above the starting PSA level) within a median of 8 weeks after introducing transdermal therapy. This increase was reversed in seven of the 12 patients who recommenced DES therapy.

CONCLUSION

Although the use of transdermal oestrogen is currently attracting enthusiasm as a first-line treatment for prostate cancer, these results show that for second- or third-line therapy further cautious research with careful monitoring is necessary.

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