Indian Journal of Urology Users online:4699  
Home Current Issue Ahead of print Editorial Board Archives Symposia Guidelines Subscriptions Login 
Print this page  Email this page Small font sizeDefault font sizeIncrease font size
Year : 2003  |  Volume : 19  |  Issue : 2  |  Page : 129-134

Estramustine phosphate in the treatment of hormone escape prostatic carcinoma - a 3 year follow-up

1 Department of Urology, Western General Hospital, Lothian University Hospitals NHS Trust, Edinburgh, United Kingdom
2 Southern General Hospital, Glasgow, United Kingdom

Correspondence Address:
Altaf H Syed
Department of Urology, Western General Hospital, Lothian University Hospitals NHS Trust, Edinburgh, EH4 2XU
United Kingdom
Login to access the Email id

Source of Support: None, Conflict of Interest: None

Rights and PermissionsRights and Permissions

Objective: A recent literature review has shown rekin­dled interest in the use of estramustine phosphate (EMP) inpatients with advanced prostatic cancer. This led us to assess prostate specific antigen (PSA ) response and drug tolerability following EMP therapy inpatients with hor­mone refractory prostate cancer Patients and Methods: Twenty-five patients with a mean age of 73.5 years (range 49 to 85 years) received EMP for hormone insensitive prostate cancer from January 1996 onwards. They were received at 6 weeks initially followed by 3 monthly intervals to monitor further progression of disease. At each visit clinical examination and blood chem­istry (PSA, etc) was done and further investigations, i.e., bone scan, CT scan, etc. were requested if thought neces­sary. Results: According to the WHO score of pain 71 %found immediate symptomatic relief following EMP treatment but only 29% were pain free after one year PSA level showed a persistent decline of >50% of pre-treatment value in 16 patients (64%) at 6 weeks. However, at 1 year 22% had either a still declining PSA or had reached a stable nadir PSA level while the rest showed rising PSA suggesting in­sensitivity to EMP. Three out of 5 patients (excluding I patient with intolerance at 2 months) with >80% decrease in PSA at 6 weeks had longer period of progression free interval (1 year in 2 and 2 years in 1 patient). The treat­ment was generally well tolerated (72%) as only 7 patients had to discontinue EMP because of severe side ef­fects. Conclusions: EMP treatment in patients with hormone escaped prostatic cancer does produce immediate PSA response which is reflected simultaneously in pain improve­ment in the majority of cases but overall the benefit is shortlived. Patients who have >80% reduction in pre-treat­ment PSA value at 6 weeks may have longer period of pro­gressionfree intervals. However EMP was generally well tolerated.

[FULL TEXT] [PDF Not available]*
Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)

 Article Access Statistics
    PDF Downloaded0    
    Comments [Add]    

Recommend this journal