2{alpha} 3{alpha}-Epithio-5{alpha}-androstan-17{beta}-ol in Treatment of Gynecomastia

1. 1. The clinical effect of epitiostanol, a new anti-estrogenagent (2,3-epithio-5a-androstan-17ß-ol) against gynecomastiawas studied in comparison with dromostanolone propionate infifty-four patients ranging from twenty to fifty years in agewithout previous history of hormone therapy and with normalliver function. The experiment was performed for eight weeksby double blind methods in three dosage groups, epithiostanol10 mg, and 20 mg and dromostanolone propionate 50 mg.
2. 2. Epithiostanol20 mg was most effective with regards to effecton mass sizeand tenderness, (effective in 96%, 20/21), followedby 10 mgepitiostanol (effective in 89%, 16/18) and dromostanolonepropionate50 mg (effective in 89%, 16/18) in descending order.No sideeffects were observed in any of the three groups.
3. 3. Basedon the results of the present study, epitiostanol isconcludedto be at least as effective as dromostanolone propionateagainstgynecomastia and to be safe from the viewpoint of sideeffects.A satisfactory therapeutical effect on gynecomastiacan be expectedwith a weekly dosage of 20 mg of epitiostanolfor an administrationperiod of between five to eight weeks.

Present Address: Department of Surgery, Keio University Hospital,Shinanomachi, Shin-juku-ku, Tokyo, Japan.     

Hypercalcemia Associated With Neoplastic Diseases

Hypercalcemia was observed most frequently in patients withadvanced breast cancer, following which the order of occurrencewas in lung, cervix, esophagus and tongue cancer patients, andmyeloma patients. The shortening of Q – aTc interval onthe electrocardiogram was remarkable and served as a usefulindicator in the early detection of hypercalcemia. The loweredserum phosphorus level was often observed in hypercalcemia inpatients with skeletal metastases. Metabolic alkalosis in hypercalcemiawas probably due to hypochloremia or hypopotassemia. The degreeof calcium deposition along the renal tubules was proportionalto the duration of hypercalcemia. Corticosteroid administrationwas effective in the treatment of hypercalcemia. However, patientsdied frequently of uremia when hypercalcemia persisted for morethan 20 days. The mechanism of hypercalcemia associated withneoplastic diseases is discussed.     

Effects of Hypophysectomy on Patients With Advanced Breast Cancer in Relation to Pituitary Hormone Reserve Before and After the Operation

In four patients with advanced breast cancer, the TSH, prolactin,LH and FSH reserve was measured, before and after hypophysectomy,by stimulation with TRH and LH-RH. Two out of the four patientswere objectively improved following the operation. It was foundthat the clinical effects of hypophysectomy did not correlatewith changes in secretion of any of these pituitary hormones.In addition, the complete absence of pituitary hormones afteroperation did not necessarily mean that treatment had been effective. ^*This study was supported by Grants for Cancer Research andfor Specific Diseases from the Ministry of Health and Welfareand by a Grant-in-Aid for Cancer Research from the Ministryof Education, Science and Culture, Japan     

The Clinical Effect of 2, 17-Dihydroxy-4, 4-Dimethyl-1, 5-Androstadien-3-One on Advanced Breast Cancer

One of synthetic diosphenol steroid derivatives, 2, 17–dihydroxy–4,4–dimethyl–l,5–androstadien–3–one(40 mg three times a week) was given to 35 patients of advancedbreast cancer. Six cases (17%) among them had objective regressions,and four (11%) had subjective improvement alone.These resultswere compared with those of 38 control patients who were treatedby testosterone propionate (100 mg three times a week). Fivecases (13%) among control women had objective regression, andfive (13%) had subjective improvement alone. The absence ofany side effects including hormonal one was confirmedin thetreated cases with the new compound. It is conceivable thatantimammary-tumor activity is almost perfectly free from hormonalactivity ofthis compound and so the compound is promising forclinical use for advanced breast cancer.     

2{alpha},3{alpha}-Epithio-5{alpha}-androstan-17{beta}-yl 1-Methoxycyclopentyl Ether in the Treatment of Advanced Breast Cancer --A Preliminary Clinical Trial--

A new orally active anti-estrogenic steroid, 2,3-epithio-5-androstan-17ß-yl1-methoxycyclopentyl ether (10364-S) was given to 41 advancedbreast cancer patients. Most patients were given a daily doseof 20 mg. The study was preliminary and not a controlled trialusing an already proven androgenic steroid. The remission rateon giving this compound to advanced breast cancer was 11/41or 26.8% and the average duration of the remission was 10.5months. Hoarseness (8/41, 19.5%) and hirsutism (5/41, 12.2%) were relativelyoften seen as virilizing side effects. No unfavorable effectson the hematopoietic organs, the liver or on calcium metabolismwere recognized in the study.