TESTICULAR ANDROGENS IN PROSTATE-CANCER PATIENTS TREATED WITH A LUTEINIZING-HORMONE-RELEASING HORMONE AGONIST

Luteinizing hormone releasing hormone agonists have been shown to redu ce the levels of androgens in the peripheral circulation and to reduce prostate volume. The objective of this study was to quantify testicul ar function in patients with metastatic carcinoma of the prostate trea ted with a luteinizing hormone releasing hormone agonist, leuprolide, by analysis of spermatic vein blood for testosterone and androstenedio ne, and by determination of the maximum velocity of the 17 beta-hydrox ysteroid oxidoreductase enzyme in testicular tissue in vitro. A chemic al analysis of the spermatic vein blood of 19 patients with a median a ge of 78 years revealed the presence of significantly high levels of t estosterone and androstenedione, 20.7 +/- 1.9 mu g.% and 6.7 +/- 0.7 m u g.%, respectively. These androgens could not be detected in patients treated with leuprolide before orchiectomy. Patients treated with leu prolide for several months followed by a period of no treatment before orchiectomy secreted testosterone and androstenedione levels comparab le to the control group. The maximum velocity of the 17 beta-hydroxyst eroid oxidoreductase enzyme in vitro in the testes of the leuprolide t reated patients was significantly inhibited. Enzyme activity returned to normal levels when leuprolide treatment was followed by a recovery period of no treatment before orchiectomy.