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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.
Key words
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Article Info
Publication History
Accepted:
October 11,
2006
Received in revised form:
September 28,
2006
Received:
July 26,
2006
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© 2006 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
