Steroid Secretion by the Human Testis. In: Rosemberg E, Paulsen CA, editors. The Human Testis. Boston: Springer US; 1970. pp. 407-21. [DOI: 10.1007/978-1-4615-9008-8_30]

Combination treatment in M1 prostate cancer

The treatment of advanced prostate cancer is based on hormone manipulation to eliminate the trophic effect of testosterone on sensitive androgen tissue of the tumor. In this study, we evaluated the efficacy of the partial androgen blockage versus the complete androgen blockage. One hundred, twenty-two patients were entered in this study and randomly were treated with buserelin alone or with buserelin and flutamide. The group that received buserelin was given cyproterone acetate (200 mg/day) during first 3 weeks of treatment to avoid "flare-up". During the follow-up (range 0-244 +/- 1 weeks), we evaluated 59 patients (61.4%) that had positive response and 37 patients (38.6%) that showed progressive disease: There were no statistically significant differences between the two treatment groups, not even in the evaluation of median time to response and of median time to treatment failure. In conclusion, the results emphasize that total androgenic blockage is as effective as a luteinizing hormone-releasing hormone analog used alone.

Endocrine control and physiology of the prostate

The endocrine control of prostatic physiology and anatomy is reviewed with emphasis on those factors in the hypothalamus and anterior adenohypophysis which affect the gland either directly or through the testes. The role of circulating estrogens and androgens and their binding to plasma proteins is presented, and the intracellular metabolism of testosterone, particularly in relation to specific receptors, is summarized. The possible significance of intracellular events in prostate cancer development is considered with particular emphasis on those parameters which may reside outside the endocrine effects on the prostatic cells.