Prognostic Significance of Monitoring Serum Testosterone in Primary ADT for Prostate Cancer
In the 1940s, Charles Huggins et al. published a paper describing the clinical benefits of surgical castration and estrogen administration in prostate cancer patients. Later, Huggins was awarded the Nobel Prize to acknowledge the importance of his findings in this field. Since that time, androgen deprivation therapy (ADT) remains a standard therapy for metastatic prostate cancer. Although the main aim of ADT is the control of the serum testosterone (TST) level below the castration level, a series of evidences indicated the clinical significance of controlling the serum TST level even below the standard castration level. In terms of TST production, multiple pathways exist, such as “classical pathway” and “backdoor pathway.” Upregulation of such pathways, even inside the tumor, contributes to the acquisition of castration resistance. Thus, monitoring serum TST levels provides us further understanding of tumor behavior in individual patients. In this chapter, we will discuss the prognostic significance of monitoring serum TST levels in primary ADT for prostate cancer.
KeywordsAndrogen deprivation therapy Testosterone Prostate cancer LHRH analog GnRH antagonist
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