Estrogen therapy for prostate cancer

Abuse of male hormones is a high-risk factor for prostate disease. If you have prostate cancer and try to improve your sexual function with male hormones, it will also aggravate your condition. Estrogen treatment can achieve good results. Estrogen can inhibit the release of luteinizing hormone from the anterior pituitary gland, eliminate the stimulation of testosterone produced by testicles on the prostate, and estrogen may also directly inhibit the production of testosterone.

The commonly used estrogen drugs are mainly the following:

(1) Diethylstilbestrol. It inhibits the secretion of pituitary gonadotropin through feedback, thereby inhibiting the production of testosterone by the testicles and reducing the concentration of free testosterone. Usage: Oral administration of 3-5 mg or more per day, with a maintenance dose of 1-3 mg/day. There are adverse reactions such as nausea, vomiting, edema, impotence, breast tenderness, and thrombophlebitis.

(2) Estradiol polyphosphate. This drug is a long-acting preparation that is injected intramuscularly once a month, 80-160 mg each time. It has fewer adverse reactions than diethylstilbestrol.

(3) Ethinyl estradiol (ethinyl estradiol). The dosage is 0.05-0.5 mg each time, 3-6 times a day, and the adverse reactions include dizziness, nausea, vomiting, etc.

(4) Trimethoprim-sulfamethoxazole. Oral administration: 12 mg each time, once every other day.

(5) Estrogen plus orchiectomy is effective in treating bone pain and distant metastasis. The efficacy of first-time patients is as high as 80%, and bone metastases can be seen, and enlarged prostate and tumor nodules shrink or disappear.

The phosphodiesterase (PDE4D4) gene has been of great interest. Studies have shown that methylation of the PDE4D4 gene causes permanent changes in the gene's expression pattern in the prostate. Under normal circumstances, the PDE4D4 gene is no longer expressed in adulthood; however, after early exposure to BPA or estradiol, the exposed animals continue to express the PDE4D gene at high levels. This phenomenon can also be observed in prostate cancer cells. The methylation marks formed by epigenetic gene rearrangements precede the development of the disease, so methylation can be used as a marker to identify people at high risk of prostate cancer.