DES Can Prevent Adverse Bone Effects of Prostate Cancer Therapy

NEW YORK (Reuters Health) Mar 01 – The estrogenic agent diethylstilbestrol (DES) can provide an antiandrogenic effect in the treatment of prostate cancer without the rapid bone turnover associated with conventional androgen deprivation therapies, according to a report in the February issue of The Journal of Urology
In their introduction the authors note that, currently, the most commonly employed androgen deprivation agents are luteinizing hormone releasing hormone (LHRH) agonists and non-steroidal antiandrogens. However, because their use has been tied to osteoporosis, interest in estrogen therapy, a much older treatment method, has been renewed.

Dr. Douglas Scherr and colleagues, from Cornell Medical Center in New York, evaluated bone turnover in 54 men with localized prostate cancer and in 24 men with benign prostatic hyperplasia (BPH). Of the men with cancer, 20 underwent radiation alone, 20 received 1-mg/day DES monotherapy, and 14 received DES in addition to an LHRH agonist or after undergoing orchiectomy. None of the men with BPH received hormonal therapy.

Urinary levels of collagen type I N-telopeptides, a marker for bone turnover, were determined at 3 separate monthly visits. Men who received DES had similar levels of N-telopeptide as men with BPH, and significantly lower levels than men who received androgen deprivation therapy without DES (p < 0.05). …

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