Dramatic Decline of PSA and Symptom Improvement after Estramustine Withdrawal in a Hormone-refractory Prostate Cancer Patient

Kyo Ik Mo; Ki Ho Kim; Young Jin Seo; Kyung Seop Lee

doi:10.4111/kju.2007.48.7.751

Journal List > Korean J Urol > v.48(7) > 1004968

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Mo, Kim, Seo, and Lee: Dramatic Decline of PSA and Symptom Improvement after Estramustine Withdrawal in a Hormone-refractory Prostate Cancer Patient

Original Article

Korean J Urol 2007;48(7):751-753.

Published online: 20 January 2007

DOI: https://doi.org/10.4111/kju.2007.48.7.751

Dramatic Decline of PSA and Symptom Improvement after Estramustine Withdrawal in a Hormone-refractory Prostate Cancer Patient

Kyo Ik Mo, Ki Ho Kim, Young Jin Seo, Kyung Seop Lee

From the Department of Urology, College of Medicine, Dongguk University, Gyeongju, Korea

동국대학교 경주병원 비뇨기과 경북 경주시 석장동 1090-1번지 ? 780-350 TEL: 054-770-8265 FAX: 054-771-0769 E-mail: ksleemd@ dongguk.ac.kr

Received 19 April 2007 Accepted 23 May 2007

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

In some patients with prostate cancer and who manifest disease progression during maximal androgen blockade (MAB) therapy, discontinuation of antiandrogen treatment might result in a significant fall in the level of serum prostate-specific antigen (PSA), and this is often correlated with clinical improvement (antiandrogen withdrawal syndrome). However, a decline in the PSA level after the withdrawal of estramustine phosphate is extremely rare. We report here on a case of dramatic decline in the PSA level after withdrawal of estramustine phosphate in a patient with hormone refractory prostate cancer.

Keywords: Prostate cancer, Estramustine, Chemotherapy

References

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Fig. 1.

Serial changes of bone scan finding. (A) Initial bone scan, (B) 38 months later (after second line hormone therapy), (C) 57 months later (after estramustine withdrawal).

Fig. 2.

Clinical course. The serum prostate-specific antigen (PSA) level declined dramatically after the withdrawal of estramustine phosphate. PSA: prostate-specific antigen, MAB: maximal androgen blockade, GnRH: gonadotrophin releasing hormone, K: ketoconazole, P: prednisolone, E: estramustine, V: vinblastine.

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