Hormonal changes in Egyptian patients suffering from prostate cancer and benign prostate hyperplasia

Abstract

Abstract: Prostate cancer is the most common malignancy among men. Hormonal factors play an important role in growth of prostate tissue and induction of prostate carcinogenesis. The use of sequential hormonal therapies is a common practice in the systemic therapy of advanced prostate cancer. The aim of this study is to clarify the possibility of use the measuring serum level of androgens (testosterone (T) and adrenal androgens dehydroepiandrostenedione sulphate (DHEA-s) and androstenedione (AD)), gonadotropins (Follicle-stimulating hormone (FSH) and luteinizing hormone (LH)) to improve the accuracy of diagnostic serum prostate specific antigen (PSA), and to examine the effect of these parameters in the progression of prostate cancer from androgen dependent to androgen independent after orchiectomy. Results indicated that serum DHEA-s level showed insignificant decrease in hyperplasia group as compared to androgen independent group (P = 0.185) and a significant decrease in hyperplasia group as compared to androgen dependent group (P = 0.001) while, no significant variation was found between androgen dependent and androgen independent groups (P = 0.341). Combination of PSA and DHEA-s increase the sensitivity of PSA to differentiate between benign hyperplasia and cancer from 93.5% to 96.8%. Serum FSH showed no statistically significant variation between androgen dependent group and hyperplasia group (P = 0.109), while, there was a highly significant increase in androgen independent group as compared to androgen dependent (P = 0.002) and hyperplasia groups (P = 0.001). Serum LH showed statistically significant increase in androgen dependent group (P = 0.001) and androgen independent group (P = 0.001) as compared to hyperplasia group, also, there were a statistically significant variation was found between androgen dependent and androgen independent groups (P = 0.002). Serum T showed statistically significant decrease between androgen dependent group and hyperplasia group (P = 0.021). Also, there was a highly significant decrease in androgen independent group as compared to androgen dependent and hyperplasia groups (P = 0.001). It can be concluded that measuring of DHEA-s together with PSA can be used to increase the differentiation between prostate cancer and BPH and controlling of adrenal androgens and gonadotropin hormones (FSH & LH) would be efficient in delaying the transformation of prostate cancer from androgen dependent to androgen-independent.