Parenteral Estrogens for Prostate Cancer: Can a New Route of Administration Overcome Old Toxicities? |
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| Affiliation: | 1. Division of Hematology and Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland;2. Division of Urology, Oregon Health &Science University and Portland VA Medical Center;1. Department of Mathematics, National Institute of Technology Delhi, Delhi 110077, India;2. Biomechanics and Aerospace Research, Department of Engineering and Mathematics, Sheffield Hallam University, Sheffield, S1 1WB England, UK;1. Department of Aerospace and Mechanical Engineering, The University of Arizona, Tucson, AZ 85721, USA;2. Departments of Biomedical Engineering, The Pennsylvania State University, University Park, PA 16802, USA;3. College of Medicine, The University of Arizona, Tucson 85724, USA;4. GeneFluidics Inc., Irwindale, CA 91010, USA;5. Department of Urology, Stanford University, Stanford, CA 94305, USA;6. Departments of Mechanical and Nuclear Engineering, The Pennsylvania State University, University Park, PA 16802, USA;7. Department of Surgery, Milton S. Hershey Medical Center, The Pennsylvania State University, Hershey, PA 17033, USA;1. Thrombosis and Haemostasis Research Unit, Department of Clinical Biochemistry, Aarhus University Hospital, Aarhus N, Denmark;2. Sexological Centre, Aalborg University Hospital, Aalborg, Denmark;3. Department of Clinical Medicine, Aarhus University, Aarhus, Denmark;1. Department of Geology, University of Malaya, 50603 Kuala Lumpur, Malaysia;2. Department of Geology, Ekiti State University, P.M.B. 5363, Ado-Ekiti, Nigeria;3. Geology Department, Faculty of Applied Science, Taiz University, 6803 Taiz, Yemen;1. Department of Oncology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China;2. Academy of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou 350122, China;3. Fujian Key Laboratory of Integrative Medicine in Geriatrics, Fuzhou 350122, China |
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| Abstract: | ![]()
Androgen deprivation therapy (ADT) is the mainstay of management of advanced-stage prostate cancer and recently has been shown to improve survival when administered in earlier stages of the disease. The oncologic benefits of ADT might be partially offset, however, by a reduction in quality of life because of adverse effects. In addition to the well-recognized adverse consequences of ADT, recent evidence suggests that ADT is associated with dyslipidemia, impaired glucose metabolism, adverse body compositional changes, and osteoporosis. Therefore, there is a pressing need to develop less toxic forms of ADT. A novel approach to this problem is the use of estrogen to induce androgen suppression. Whereas oral estrogen therapy is known to be associated with thromboembolic complications, studies of parenteral estrogen in men with prostate cancer suggest that the use of parenteral estrogen achieves target androgen suppression, does not adversely affect prothrombotic protein levels, and is not associated with adverse metabolic, skeletal, and body compositional changes when compared with conventional ADT. Herein, we review the data for parenteral estrogen use in prostate cancer, the antineoplastic mechanisms of action of estrogen in prostate cancer, the potential advantages of parenteral estrogen compared with conventional ADT, and the remaining barriers in the use of parenteral estrogen in prostate cancer. |
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