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CA: A Cancer Journal for Clinicians, Vol 22, 232-240, Copyright © 1972 by American Cancer Society

Studies on Prostatic Cancer

I. The Effect of Castration, Of Estrogen and of Androgen Injection on Serum Phosphatases in Metastatic Carcinoma of the Prostate

1. The content in serum of phosphatase with activity maximum at pH 5 in normal men and in men with benign prostatic hypertrophy was 3.25±1.37 King and Armstrong units in 100 cc. Serum phosphatase with activity maximum at pH 9.3 in this control group was 7.9±2.1 units in 100 cc.

2. In a group of 25 men with roentgenologic evidence of metastatic carcinoma to the bony pelvis, both acid and alkaline phosphatases were increased above normal in 19 cases, only alkaline phosphatase was increased in 2 cases, and both values were within normal limits in 4 cases. Metastatic carcinoma of the prostate may be present in bones when the phosphatases of serum are normal, but when acid phosphatase is present in activity greater than 10 units in 100 cc., disseminated prostatic cancer is present.

3. In prostatic cancer with marked elevation of acid phosphatase, castration or injection of large amounts of estrogen caused a sharp reduction of this enzyme to or towards the normal range. Alkaline phosphatase values rose following castration and then decreased, but more slowly than acid phosphatase. In certain cases, these values reached and were maintained in a normal range during the period of observation, 180 days, while in other patients the values were slightly above normal.

4. In 3 patients with prostatic cancer, androgen injection caused a sharp rise of serum acid phosphatase. In 1 case following cessation of androgen there was a decrease of the acid phosphatase followed by a secondary spontaneous rise.

5. Acid phosphatase does not readily cross membranes from the blood, since it was present only in traces in cerebrospinal and spermatocele fluids when concurrent serum level was high.

6. Prostatic cancer is influenced by androgenic activity in the body. At least with respect to serum phosphatases, disseminated carcinoma of the prostate is inhibited by eliminating androgens, through castration or neutralization of their activity by estrogen injection. Cancer of the prostate is activated by androgen injections.

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