Urinary Excretion of Estrone, Estradiol and Estriol by Patients with Prostatic Cancer and Benign Prostatic Hypertrophy

Estrogenic Management of Benign Prostatism, Including Early and Poor‐risk Cases: 7‐year Experience*

“…Rosenkrantz and associates (145) commented: “Acid phosphatase in the prostate may be very important in the metabolism of that organ, and a search for inhibitors of the biosynthetic pathways of prostatic acid phosphatase may be fruitful in an attack on carcinoma of the prostate.” Similarly, Flocks (146) has stated: “Such systemic treatment—stilbestrol diphosphate in large intravenous doses, stilbestrol diphosphate with P 32 intravenously, thio‐ tepa , nitrogen mustard and other alkylating agents—needs further investigation, not only as adjunctive therapy for the disseminated stage of prostatic carcinoma, but also for the earlier, more localized stages.” The following general data also suggest the merit of this perspective: Prostatic carcinoma generally develops in glands that already exhibit BPH (147). The multiple tumor foci in prostatic carcinoma (147) are consistent with the influence of systemic carcinogenic factors. The higher incidence of lung cancer among males has been interpreted (90a) as indicative of a “more protective endocrine environment” in women. Berndt (90b) suggested the therapeutic value of estrogens in men with bronchial carcinoma. In this same context, Oota (148) reported a two‐fold predominance of primary hepatic cancer among males, based on a sex‐corrected distribution for overall autopsies. Equally pertinent are the apparent earlier development of experimental hepatoma in male rats (148), and the increased incidence of spontaneous hepatomas induced in female mice by testosterone (149).…”

“…An absolute increase in the amount of estriol in breast cancer patients without a concomitant decrease in the absolute levels of estrone and estradiol has been demonstrated (89), raising the possibility of estriol precursors from the adrenals, other than estrone or estradiol (89c). Analysis of the urinary concentration of estrogen metabolites in cases of pulmonary neoplasm by Marmorston and associates (90) provides in‐sights concerning another group of tumors predominantly affecting males. The following data were pertinent: 1) the excretion of estrone and estradiol by men with lung cancer of the anaplastic type was significantly lower than that by healthy controls and by men having lung cancer of the adenocarcinoma type; 2) whereas patients with lung cancer of the adenocarcinoma group excreted more urinary estrogens, they had a lower incidence of BPH (12 per cent, as compared with 20 per cent or more in the other groups); 3) patients with lung cancer of the adenocarcinoma and epidermoid types excreted proportionately more estrone than aldosterone in comparison with healthy controls; and 4) men with lung cancer of the anaplastic type excreted proportionately less estrone than pregnanediol, suggesting interference from the 21‐carbon precursors (pregnenolone and progesterone) to 18‐carbon (via 19‐carbon) steroids.…”

Endocrinology of the Aging Prostate: Current Concepts

“…Recent studies suggest that not only low T levels, but also an increase of estrogens may favor BPH/LUTS progression ( 10 ). Marmorston and colleagues first reported that the E 2 /T ratio in 24-h urinary collections was elevated in men with BPH compared to normal controls ( 49 ). Other epidemiologic studies have found an association between BPH and higher serum estrogen levels or estrogen/androgen ratio ( 50 , 51 ).…”

Benign Prostatic Hyperplasia: A New Metabolic Disease of the Aging Male and Its Correlation with Sexual Dysfunctions

“…In addition, the enzyme P450 aromatase which converts androgens to estrogens [27] is highly expressed not only in fat tissue but also in the urogenital tract [28]. Evidence of an increased estrogen/androgen ratio was originally provided by Marmorston et al almost half a century ago [29] reporting that the estrogen/androgen ratio in 24-hour urinary collections was elevated in men with BPH, as compared to normal controls. Several studies have observed a correlation between plasma 17 β estradiol (17 β E 2 ) levels and prostate volume or other features of BPH [30–32], while others have not [33].…”