PTU - Polskie Towarzystwo Urologiczne
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The role of serum testosterone concentration in patients under hormonal therapy due to prostate cancer
Article published in Urologia Polska 2007/60/2.


Jakub Dobruch, Andrzej Borówka
Klinika Urologii Centrum Medycznego Kształcenia Podyplomowego, I Zespół Dydaktyki Urologicznej - Oddział Urologii Międzyleskiego Szpitala Specjalistycznego w Warszawie


prostate, testosterone, prostate cancer, hormonal therapy


Prostate cancer (PCa) is one of the most common neoplasm found in men. The fundamental way of treatment of patients with advanced stages of PCa is hormonal therapy. It is aimed at restriction of androgens influence on prostate cancer cells. The major androgen in men is testosterone (T) produced by testis. Orchiectomy is the easiest way of T elimination. Its serum concentration (s.T) decreases below 50 ng/ml, which is commonly accepted as castrate level. LHRH analogues are the alternative to orchiectomy. Their efficacy may be confirmed by measurement of testosterone level. In this paper influence of new technologies of testosterone measurements on its castrate levels and their relation with assessment of LHRH analogues efficacy are discussed.


  1. http: // (20/03/2007).
  2. Parkin DM, Bray FI, Devesa SS: Cancer burden in the year 2000: the global picture. Eur J Cancer 2001, 37 (suppl 8), 4-66.
  3. Farkas A, Schneider D, Perrotti M et al: National trends in the epidemiology of prostate cancer, 1973 to 1994: evidence for the effectiveness of prostate-specific antigen screening. Urology 1998, 52, 444-448.
  4. Paquette EL, Sun L, Paquette LR et al: Improved prostate cancer-specific survival and other disease parameters: impact of prostate-specific antigen testing. Urology 2002, 60, 756-759.
  5. Chu KC, Tajone RE, Freeman HP: Trends in prostate cancer mortality among black and white men in the United States. Cancer 2003, 97, 1507-1516.
  6. http: // (20/03/2007).
  7. Dobruch J, Borówka A, Antoniewicz AA, Chłosta P: Epidemiology of prostate cancer: changes observed in Poland in 1991-2000. Urol Pol 2005, 58, 26-30.
  8. Dobruch J, Modzelewska E, Popiel M et al: Prostate cancer clinical stage at diagnosis. Urol Pol 2006, 59, 269-274.
  9. Huggins C, Hodges CV: Studies on prostatic cancer. I. The effect of castration, of estrogen and of androgen injection on serum phosphatase in mestastatic carcinoma of the prostate. Cancer Res 1941, 1, 293-297.
  10. Walsh PC: Physiologic basis for hormonal therapy in carcinoma of the prostate. Urol Clin N Am 1975, 2, 125-140.
  11. Denis L: Prostate cancer. Primary hormonal treatment. Cancer 1993, 71, 1050-1058.
  12. Rennie PS, Bruchovsky N: In vitro and in vivo studies on the functional significance of androgen receptors in rat prostate. J Biol Chem 1972, 247, 1546-1554.
  13. Wilson EM, French FS: Binding properties of androgen receptors. Evidence ofor identical receptors in the rat testes, epididymis, and prostate. J Biol Chem 1978, 251, 5620-5629.
  14. Coffey DS. Walsh PC: Clinical and experimental studies in benign prostatic hyperplasia. Urol Clin N Am 1990, 17, 461-476.
  15. Murphy GP, Beckley S, Brady MF et al: Treatment of newly diagnosed metastatic prostate cancer patients with chemotherapy agents in combination with hormones versus hormones alone. Cancer 1983, 51, 1264-1272.
  16. The Veterans Administration Co-operative Urological Research Group. Treatment and survival of patients with cancer of the prostate. Surg Gynecol Obstet 1967, 124, 1011-1017.
  17. Melton RJ 3rd, Alothman KI, Achenbach SJ et al: Decline in bilateral orchiectomy for prostate cancer in Olmsted county, Minnesota, 1956-2000. Mayo Clin Proc 2001, 76: 1199-1203.
  18. Burger HG, Kent JR, Kellie AE: Determination of testosterone in human peripheral and adrenal venous plasma. J Clin Endocrinol 1964, 24, 432-437.
  19. Wilke TJ, Utley DJ: Total testosterone, free-androgen index, calculated free testosterone, and free testosterone by analog RIA compared in hirsute women and in otherwise-normal women with altered binding of sex-hormone-binding globulin. Clin Chem 1987, 33, 1372-1375.
  20. Borówka A: Leczenie raka gruczołu krokowego. Terapia i Leki 1980, 7/30, 41-47.
  21. Zherdev AV, Byzova NA, Izumrudov VA, Dzantiev BB: Rapid polyelectrolyte-based immunofiltration technique for testosterone detection in serum samples. Analyst 2003, 128, 1275-1280.
  22. Oefelein MG, Feng A, Scolieri MJ et al: Reassessment of the definition of castrate levels of testosterone: implications for clinical decision making. Urology 2000, 56, 1021-1024.
  23. Lin BJ, ChenKK, ChenMT, Chang LS: The time for serum testosterone to reach castrate level after bilateral orchiectomy or oral estrogen in the management of metastatic prostatic cancer. Urology 1994, 43, 834-837.
  24. Vogelzang NJ, Chodak GW, Soloway MS et al: Zoladex Prostate Study Group. Goserelin versus orchiectomy in the treatment of advanced prostate cancer: final results of a randomized trial. Urology 1995, 46, 220-226.
  25. Schally AV, Kastin AJ, Arimura A: Hypothalamic FSH and LH regulating hormone. Structure, physiology and clinical studies. Fertil Steril 1971, 22, 703-721.
  26. Garnick MB, Glode LM for the Leuprolide Study Group. Leuprolide versus diethylstilbestrol for metastatic prostate cancer. N Engl J Med. 1986, 311, 1281-1286.
  27. Heyns CF, Simonin M-P, Grosgurin P et al: Comparative efficacy of triptorelin pamoate and leuprolide acetate in men with advanced prostate cancer. BJU International 2003, 92, 226-231.
  28. Oefelein MG, Cornum R: Failure to achieve castrate levels of testosterone during luteinizing hormone releasing hormone agonist therapy: the case for monitoring serum testosterone and a treatment decision algorithm. J Urol 2000, 164, 726-729.
  29. Chu FM, Jayson M, Dineen MK et al: A clinical study of 22.5 mg. La-2550: A new subcutaneous depot delivery system for leuprolide acetate for the treatment of prostate cancer. J Urol 2002, 168, 1199-1203.
  30. Mahler C: Is disease flare a problem? Cancer 1993, 72 (12 suppl), 3799-3802.
  31. Borówka A, Antoniewicz AA, Chłosta P: Leczenie przerzutów nowotworowych do kości u chorych na raka gruczołu krokowego. W: Przerzuty nowotworowe do kości - nowe kierunki leczenia. Red Pawlicki M, Medica Press, Bielsko Biała 2004, 116-160.
  32. Tombal B: Appropriate castration with Luteinising Hormone Releasing Hormone (LHRH) agonists: what is the optimal level of testosterone. Eur Urol Suppl 2005, 4, 14-19.
  33. Kaisary AV, Tyrrell CJ, Peeling WB, Griffiths K: Comparison of LHRH analogue (Zoladex) with orchiectomy in patients with metastatic prostatic carcinoma. Br J Urol 1991, 67, 502-508.
  34. Vogelzang NJ, Chodak GW, Soloway MS et al: Goserelin versus orchiectomy in the treatment of advanced prostate cancer: final results of a randomized trial. Zoladex Prostate Study Group. Urology 1995, 46, 220-226.
  35. Parmar H, Edwards L, Phillips RH, et al: Orchiectomy versus long-acting D-Trp-6-LHRH in advanced prostatic cancer. Br J Urol 1987, 59, 248-254.
  36. Prostate Cancer Trialists´ Collaborative Group. Maximum androgen blockade in advanced prostate cancer: an overview od 22 randomized trials with 3283 deaths in 5710 patients. Lancet 1995, 346, 265-269.
  37. Auclair C, Stern M, Givner ML: LHRH and analogues as potential therapy for benign prostatic hyperplasia and hormone-dependent cancers. Arch Androl 1981, 7, 237-244.
  38. Oefelein MG: Time to normalization of serum testosterone after 3-month luteinizing hormone-releasing hormone agonist administered in the neoadjuvant setting: implications for dosing schedule and neoadjuvant study consideration. J Urol 1998, 160, 1685-1688.
  39. Oefelein MG: Serum testosterone-based luteinizing hormone-releasing hormone agonist redosing schedule for chronic androgen ablation: a phase I assessment. Urology 1999, 54, 694-699.
  40. Oefelein MG: Serum testosterone-based luteinizing hormone-releasing hormone agonist redosing schedule for chronic androgen ablation: a phase I assessment. Urology 1999, 54, 694-699.
  41. Oefelein MG: Health related quality of life using serum testosterone as the trigger to re-dose long acting depot luteinizing hormone-releasing hormone agonists in patients with prostate cancer. J Urol 2003, 169, 251-255.
  42. Aus G, Abbou CC, Bolla M et al: Guidelines on prostate cancer. http: // pdf.
  43. Okada H, Doken Y, Ogawa Y, Toguchi H: Preparation of three-month depot injectable microspheres of leuprorelin acetate using biodegradable polymers. Pharmaceutical Research 1994, 11, 1143-1147.
  44. Perez-Marrero R, Tyler RC: A subcutaneous delivery system for the extended release of leuprolide acetate for the treatment of prostate cancer. Expert Opin Pharmacother 2004, 5, 447-457.
  45. Perez-Marreno R, Chu FM, Gleason D et al: A six-month, open-label study assessing a new formulation of leuprolide 7.5 mg for suppression of testosterone in patients with prostate cancer. Clin Ther 2002, 24, 1902-1914.
  46. Berges R: Eligard: pharmacokinetics, effect on testosterone and PSA levels and tolerability. Eur Urol Suppl 2005, 4, 20-25.
  47. Berges R, Bello U: Effect of a new leuprorelin formulation on testosterone levels in patients with advanced prostate cancer. Curr Med Res Opin 2006, 22, 649-655.
  48. Tombal B, Berges R: HowGood do Current LHRHAgonists Control Testosterone? Can this be Improved with Eligard? European Urology Supplements 2005, 4, 30-36.
  49. Arcadi JA: Rapid drop in serum testosterone after bilateral subcapsular orchiectomy. J Surg Oncology 1992, 49, 35-38.
  50. Sartor O, Dineen MK, Perez-Marreno R et al: An eight-month clinical study of LA-2575 30.0 mg: a new 4-month, subcutaneous delivery system for leuprolide acetate in the treatment of prostate cancer. Urology 2003, 62, 319-323.
  51. Debruyne FM, Dijkman GA, Lee DC et al: A new long acting formulation of the luteinizing hormone-releasing hormone analogue goserelin: results of studies in prostate cancer. J Urol 1996, 155, 1352-1254.
  52. Heyns CF, Simonin MP, Grosgurin P et al: Comparative efficacy of triptorelin pamoate and leuprolide acetate in men with advanced prostate cancer. BJU Int 2003, 92, 226-231.
  53. Santor O: Eligard W 6: A New Form of Treatment for Prostate Cancer. European Urology Supplements 2006, 5, 905-910.


Jakub Dobruch
Oddział Urologii Międzyleskiego Szpitala Specjalistycznego
ul. Bursztynowa 2
04-749 Warszawa
tel. 0 503072230