[Recurrence of cancer of the prostate after initial treatment with diethylstilbestrol (DES) in a homogeneous series of 175 cases]

Abstract

The study of a homogeneous series of 215 cases of prostatic cancer, 175 of which received first-line treatment with diethylstilbestrol (DES) clearly demonstrated that: 1. practically all well differentiated prostatic cancers, regardless of their stage, responded remarkably well to first-line treatment with sufficient doses of DES, as, when correctly monitored, practically none of these cancers escaped and early stages of escape can be salvaged. 2. true escape occurs all the earlier and evolves all the more rapidly for advanced, poorly differentiated cancers, but this is not constant. 3. to our knowledge, confirmed true metastatic escape to effective doses of DES cannot be salvaged by another treatment, while DES has been successfully used as salvage therapy in several cases of escape to LHRH agonists. 4. the thromboembolic risks must be thoroughly evaluated and prevented by associated anticoagulant treatment. They do not constitute a formal contraindication to treatment when it is closely monitored. However, the best treatment for these cases, when accepted by the patient, appears to be a combination of castration with a daily dose of 1 to 2 mg of DES. 5. The low cost of this treatment must also be taken into account in the assessment of this treatment modality.