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Comparable amounts of sex steroids are made outside the gonads in men and women: Strong lesson for hormone therapy of prostate and breast cancer
Authors:Fernand Labrie  Leonello Cusan  José Luis Gomez  Céline Martel  René Bérubé  Patrick Bélanger  Alain Bélanger  Liesbeth Vandenput  Dan Mellström  Claes Ohlsson
Institution:1. Molecular Endocrinology and Oncology Research Center, Laval University Hospital Research Center (CRCHUL) 2705, Laurier Boulevard, Quebec City, Quebec, Canada G1V 4G2;2. Center for Bone Research at the Sahlgrenska Academy (CBS), Department of Internal Medicine and Geriatrics, Gothenburg University, Gothenburg, Sweden;1. Division of Reproductive Sciences, Oregon National Primate Research Center, Beaverton, OR 97006, United States;2. Division of Neuroscience, Oregon National Primate Research Center, Beaverton, OR 97006, United States;3. Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, OR 97201, United States;1. Departments of Cell Biology & Anatomy, New York Medical College, Valhalla, NY, USA;2. Departments of Obstetrics & Gynecology, New York Medical College, Valhalla, NY, USA;3. Departments of Pediatrics, New York Medical College, Valhalla, NY, USA;4. Departments of Neurology, New York Medical College, Valhalla, NY, USA;1. Institute of Molecular Medicine and Genetics, Medical College of Georgia at Georgia Regents University, Augusta, GA 30912, USA;2. Department of Obstetrics and Gynecology, University of Texas Health Science Center, San Antonio, TX, USA;3. Neurobiology Institute of Medical Research Centre, Hebei United University, Tangshan, Hebei 063000, PR China;2. Department of Pathology, Hadassah–Hebrew University Medical Center, Jerusalem, Israel;3. Department of Orthopedic Surgery, Hadassah–Hebrew University Medical Center, Jerusalem, Israel.;1. INSERM U693 and Univ Paris-Sud 11, Faculté de Médecine Paris-Sud, UMR-S693, Le Kremlin Bicêtre F-94276, France;2. «Carol Davila» University of Medicine and Pharmacy, Bucharest, Romania;3. Assistance Publique-Hôpitaux de Paris, Hôpital de Bicêtre, Service d’Endocrinologie et Maladies de la Reproduction, Le Kremlin Bicêtre F-94275, France;1. Polyclinique de Courlancy, 38 bis rue de Courlancy, 51100 Reims, France;2. Service d’urologie et chirurgie de la transplantation, hôpital Edouard-Herriot, 5 place d’Arsonval, 69437 Lyon Cedex 03, France;3. Département d’urologie, CHU Saint-Louis, AP-HP, Paris Inserm U955Eq7, Paris-Est Créteil, France;4. CHU Mondor, AP-HP, Inserm U955Eq07, 51 avenue du Maréchal-de-Lattre-de-Tassigny, 94000 Créteil, France;5. Service d’urologie, CHU de Bordeaux, université Bordeaux-Segalen, 33000 Bordeaux, France
Abstract:The objective of this study was comparison of circulating androgens and their metabolites as well as estrogens measured for the first time by a validated mass spectrometry technology in 60–80-year-old men and women of comparable age.Castration in men (n = 34) reduces the total androgen pool by only about 60% as indicated by the decrease in the serum levels of the glucuronide metabolites of androgens compared to intact men (n = 1302). Such data are in agreement with the 50 to 75% decrease in intraprostatic dihydrotestosterone (DHT) concentration after castration. Most interestingly, the same amounts of androgens and estrogens are found in postmenopausal women (n = 369) and castrated men of comparable age.The most significant therapeutic implication of these findings is the absolute need to add a pure (nonsteroidal) antiandrogen to castration in men with prostate cancer in order to block the action of the 25 to 50% DHT left in the prostate after castration. Not adding an antiandrogen to castration in men treated for prostate cancer is equivalent to not prescribing a blocker of estrogens in women suffering from breast cancer because they are postmenopausal and have low circulating estradiol.
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