Revista de carcinogénesis y mutagénesis

Abstracto

Antiestrogen Treatment for Androgen-Insensitive or Castration-Resistant Prostate Cancer, Identification of Estrogen Stem Cells, and Estrogen Receptors

Akhouri A Sinha

Objective: A variety of treatments (such as bilateral castration, chemical castration, adrenalectomy and hypophysectomy) have not cured adenocarcinoma of Prostate Cancer (PC). We hypothesize that sub type (s) can exist resulting in the failures of the above treatments.After Androgen Deprivation Therapy (ADT), PC emerges as androgen-insensitive or Castration-Resistant Prostate Cancer (CRPC).Our study is designed to identify a sub type of PC.

Materials and Methods: DES (diethylstilbestrol) treated and untreated prostate biopsy specimens were utilized to identify two sub-types, androgen-sensitive and androgen-insensitive, tumours. Additional studies, such as localization of isotopic estrogen and estrogen antibodies, were designed to further define the sub types of PC.

Results: Localization of isotopic estrogen showed silver grains in cancer cells and not in the controls by electron microscopic autoradiography. Estrogen antibody IgG localized in the nucleus by electron microscopy. After the removal of androgen by the ADT, estrogen-dependent stem cells and estrogen receptors were identified.

Conclusion: ADT alone does not treat the estrogen-dependent PC. PC/CRPC has caused over 375,000 deaths in the world in 2021. Both androgen and estrogen dependent PC need to be treated concurrently. Antiestrogen treatment (e.g., Tamoxifen, etc.) is the appropriate for the sub type of estrogen dependent PC.Clinical trials are expected to determine the sequence of ADT (including inhibition of Hypothalamic Luteinizing Hormone-Releasing Hormone and antiestrogen treatments, dosages, timing, and duration of treatments. Antiestrogen treatment combined with ADT, will hopefully begin an era of curing PC just as the antibiotics have cured bacterial infections.