No abstract available.
Animals ; Castration* ; Finasteride* ; Prostate* ; Rats*

No abstract available.
Castration ; Granuloma ; Granuloma, Foreign-Body

Disorders of sexual development (DSD) defined as congenital conditions associated with atypical development of anatomical, gonadal or chromosomal sex, is a rare condition that may present with ambiguous genitalia. Included in the varied classes of DSD is mixed gonadal dysgenesis which is known to be due to mosaicism, a chromosomal aberration. Mosaic individuals may have concerns on growth, hormone balance, gonadal development, sex of rearing and fertility. This case report presents an 18-year old student who presented with primary amenorrhea, delayed secondary sexual characteristics and phenotypic features of Turner syndrome who, on chromosomal analysis revealed 45X0/46XY mosaicism. The patient underwent operative laparoscopy with bilateral gonadectomy on the basis of the increased risk of development of gonadal malignancy in phenotypic females with Y-chromosome material. Histopathological analysis revealed bilateral streak gonads. Hormone replacement therapy was then initiated for the induction of secondary female sex characteristics, as treatment for estrogen deficiency, for the induction of pubertal growth spurt and for optimization of bone mineral accumulation. Management of disorders of sexual development is challenging, thus the need for a multidisciplinary approach involving experts in endocrinology, gynecology, psychology and genetics.
GONADAL DYSGENESIS, MIXED ; MOSAICISM ; TURNER SYNDROME ; CASTRATION

The hormonal sensitivity of prostate cancer has been exploited clinically since Huggins and Hodges established the suppressive effects of castration on prostate cancer. Despite over sixty years of research into alternate modalities, androgen deprivation therapy (ADT) has become the mainstay treatment for locally advanced and metastatic prostate cancer. Suppression of testosterone production, the primary goal of hormonal therapy, can be achieved by a multitude of treatments. The ideal timing, duration and composition of ADT remains undefined. At the present time, first-line therapy consists of orchiectomy, luteinizing hormone-releasing hormone (LHRH) analogues or complete androgen blockade (CAB). However, new combinations and treatment settings show promise for improving outcomes and decreasing toxicity. This article provides an overview of the hormonal therapies currently used in advanced prostate cancer.
Androgen Antagonists ; Castration ; Gonadotropin-Releasing Hormone ; Orchiectomy ; Prostatic Neoplasms ; Testosterone

The management of advanced prostate cancer has evolved rapidly. Androgen deprivation therapy, through surgical or medical castration, is the cornerstone of first-line therapy for hormone-naive metastatic prostate cancer. Recently reported results of clinical trials have given answers to questions regarding the best therapeutic agents and strategies, and these have broadened the scope of evidence-based therapy in this field. Although hormone therapy is very effective, the majority of patients eventually develop resistance to hormonal manipulation, leading to so-called castration-resistant prostate cancer. For castration-resistant prostate cancer, docetaxel-based chemotherapy had been the only approved agent to show a survival benefit for several years. However, over the last five years, significant advances in the field have led to the approval of several new agents with different mechanisms of action, such as the new androgen pathway inhibitors abiraterone and enzalutamide, a new cytotoxic agent, cabazitaxel, and new bone-seeking agents such as radium-223, which have all been associated with improved quality of life and pain palliation and an increase in survival. Herein, recent developments in hormone therapy and chemotherapy for advanced prostate cancer are reviewed and some of the trials with important results are summarized. As treatment options have expanded and developed rapidly, the selection of the most appropriate agent and administration method through multidisciplinary management is much more important than simply giving newly approved agents to maximize the clinical outcome for patients with advanced, especially castration-resistant, prostate cancer.
Castration ; Drug Therapy* ; Humans ; Neoplasm Metastasis ; Prostatic Neoplasms* ; Quality of Life

Research regarding the treatment of metastatic prostate cancer has been undergoing dramatic progress. Treatment of hormone-naïve metastatic prostate cancer includes surgical castration and medical castration that lowers androgen level in the blood using drugs. Although these androgen deprivation therapies are very effective, hormone-naïve metastatic prostate cancer finally leads to castration-resistant prostate cancer because resistance to surgical or medical castration occurs. The treatment at this stage includes not only docetaxel, but also new androgen synthesis inhibitor or androgen receptor inhibitors such as abiraterone or enzalutamide, new cytotoxic anticancer agents such as carbazitaxel, and radioisotope treatment such as radium-223. Recently, studies on the effect of chemotherapy on hormone-naïve metastatic prostate cancer before the development of castration-resistant prostate cancer have been actively published. As a result, various guidelines have recommended docetaxel as the first-line therapy for hormone-naïve metastatic prostate cancer. In this manuscript, we will summarize the basic concepts of androgen deprivation therapy for hormone-naïve metastatic prostate cancer and the main results of research on chemotherapy for hormone-naïve metastatic prostate cancer.
Antineoplastic Agents ; Castration ; Drug Therapy* ; Prostate* ; Prostatic Neoplasms* ; Receptors, Androgen

PURPOSE: We evaluated the therapeutic effect of combined androgen blockade (CAB) compared with that of medical, or surgical, castration monotherapy, in the treatment of the metastatic prostate cancer. MATERIALS AND METHODS: Of 53 patients with metastatic prostate cancer, we compared the overall survival between CAB and monotherapy groups, using a Kaplan-Meier survival curve. We also compared the therapeutic effect of flutamide and bicalutamide in the CAB group. RESULTS: There were no differences in known prognostic factors between the CAB and monotherapy groups. The mean survival after treatment were 43 months in the CAB group, and 38 months in monotherapy group, with no significant difference (p=0.470). There were also no differences in the survival rates between the flutamide and bicalutamide groups (p=0.158). CONCLUSIONS: These results implicate that the CAB was no better than medical, or surgical, castration monotherapy in patients with metastatic prostate cancer, and that flutamide or bicalutamide, in CAB, resulted in similar efficacies and tolerabilities.
Castration ; Flutamide ; Humans ; Neoplasm Metastasis ; Prostate* ; Prostatic Neoplasms* ; Survival Rate

PURPOSE: We evaluated the therapeutic effect of combined androgen blockade (CAB) compared with that of medical, or surgical, castration monotherapy, in the treatment of the metastatic prostate cancer. MATERIALS AND METHODS: Of 53 patients with metastatic prostate cancer, we compared the overall survival between CAB and monotherapy groups, using a Kaplan-Meier survival curve. We also compared the therapeutic effect of flutamide and bicalutamide in the CAB group. RESULTS: There were no differences in known prognostic factors between the CAB and monotherapy groups. The mean survival after treatment were 43 months in the CAB group, and 38 months in monotherapy group, with no significant difference (p=0.470). There were also no differences in the survival rates between the flutamide and bicalutamide groups (p=0.158). CONCLUSIONS: These results implicate that the CAB was no better than medical, or surgical, castration monotherapy in patients with metastatic prostate cancer, and that flutamide or bicalutamide, in CAB, resulted in similar efficacies and tolerabilities.
Castration ; Flutamide ; Humans ; Neoplasm Metastasis ; Prostate* ; Prostatic Neoplasms* ; Survival Rate

The final analysis of the phase 3 Targeted Investigational Treatment Analysis of Novel Anti-androgen (TITAN) trial showed improvement in overall survival (OS) and other efficacy endpoints with apalutamide plus androgen deprivation therapy (ADT) versus ADT alone in patients with metastatic castration-sensitive prostate cancer (mCSPC). As ethnicity and regional differences may affect treatment outcomes in advanced prostate cancer, a post hoc final analysis was conducted to assess the efficacy and safety of apalutamide in the Asian subpopulation. Event-driven endpoints were OS, and time from randomization to initiation of castration resistance, prostate-specific antigen (PSA) progression, and second progression-free survival (PFS2) on first subsequent therapy or death. Efficacy endpoints were assessed using the Kaplan-Meier method and Cox proportional-hazards models without formal statistical testing and adjustment for multiplicity. Participating Asian patients received once-daily apalutamide 240 mg ( n = 111) or placebo ( n = 110) plus ADT. After a median follow-up of 42.5 months and despite crossover of 47 placebo recipients to open-label apalutamide, apalutamide reduced the risk of death by 32% (hazard ratio [HR]: 0.68; 95% confidence interval [CI]: 0.42-1.13), risk of castration resistance by 69% (HR: 0.31; 95% CI: 0.21-0.46), PSA progression by 79% (HR: 0.21; 95% CI: 0.13-0.35) and PFS2 by 24% (HR: 0.76; 95% CI: 0.44-1.29) relative to placebo. The outcomes were comparable between subgroups with low- and high-volume disease at baseline. No new safety issues were identified. Apalutamide provides valuable clinical benefits to Asian patients with mCSPC, with an efficacy and safety profile consistent with that in the overall patient population.
Male ; Humans ; Prostatic Neoplasms/pathology* ; Androgen Antagonists/therapeutic use* ; Prostate-Specific Antigen ; Castration ; Prostatic Neoplasms, Castration-Resistant/drug therapy*

PURPOSE: While apoptosis of the rat prostate cells has been the focus of many studies on androgen action and prostatic carcinogenesis, little is known for morphometric measurement about rat prostatic glands. Apoptosis was described as a morphologically distinct form of cell death. However, the approach of morphological assessment in one cell to define apoptosis has some disadvantages. We studied androgen ablation induced reduction of glandular epithelial cells with counting apoptotic cells and measuring glandular cell mass with image analyzer. MATERIALS AND METHODS: Male Sprague-Dawley rats were used. The morphologic changes were evaluated at 4, 7, 14 days after castration. The ventral lobe was microdissected. The distal part of it was harvested under guide of dissecting microscope. The number of apoptotic cells were quantified in Masson & trichrome stained specimens. Using image analyzer, area densities in glandular lesion of prostatic epithelium were calculated. RESULTS: After castration. the distal duct may seem to be melted down into the proximal ducts and tall columnar epithelial cells of distal duct seem to be changed into cubodial cells. The apoptotic counts were 1.00+/-0.28, 5.06+/-0.98, 6.01+/-0.97, and 2.04+/-0.70 in control, 4th, 7th and 14th day group, respectively (p<0.05), The areas of epithelial cell mass were 13874+/-3106 micrometer2. 5530+/-3244 micrometer2, 2345+/-1226micrometer2, and 1339+/-652 micrometer2. in control, 4th. 7th and 14th day group, respectively(p<0.05). CONCLUSIONS: We conclude that castration induces a more profound involution of the rat ventral prostate. After castration, the apoptotic count and reduction of the area of epithelial cell mass rapidly processed by 7th day and after that time, this process is continuously but slowly decreased until 14th day after castration. The apoptotic counts among the epithelial cells are well matched with the morphometric measurements about epithelial glands.
Animals ; Apoptosis* ; Carcinogenesis ; Castration* ; Cell Death ; Epithelial Cells* ; Epithelium ; Humans ; Male ; Prostate* ; Rats* ; Rats, Sprague-Dawley