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Cost Comparison of Parenteral Estrogen and Conventional Hormonal Treatment in Patients With Prostatic Cancer

Published online by Cambridge University Press:  10 March 2009

Peter Henriksson  and
Reinhard Stege
Peter Henriksson
Affiliation:
Huddinge University Hospital and Karolinska Institute
Reinhard Stege
Affiliation:
Huddinge University Hospital
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Abstract

The present study compares the cost of antitumor therapy and adverse cardiovascular effects during the first year of treatment with oral estrogens, nonoral estrogens, or surgical castration in patients with prostatic cancer. We found a much higher cost for patients treated with orchidectomy and oral estrogens than for patients treated with nonoral estrogens. Twenty-five percent of the patients treated with oral estrogen suffered cardiovascular complications, compared to none of the patients treated by orchidectomy or nonoral estrogens. The initial cost of orchidectomy as compared to nonoral estrogen treatment was shown not to be balanced within the expected survival time of patients with advanced prostatic cancer. Furthermore, surgical castration causes psychological trauma to the patient. We recommend parenteral estrogen therapy as a low-cost therapeutic regimen in patients with prostatic cancer.

Type
General Essays
Information
International Journal of Technology Assessment in Health Care , Volume 7 , Issue 2 , Spring 1991 , pp. 220 - 226
Copyright
Copyright © Cambridge University Press 1991

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References

1.Bailar, S. C., III, & Byar, D. P.Estrogen treatment for cancer of the prostate. Early results with 3 doses of diethylstilbestrol and placebo. Cancer, 1970, 26, 257–61.3.0.CO;2-9>CrossRefGoogle ScholarPubMed
2.Damber, M. G., Sandstrom, B., von Schoultz, B., & Stigbrand, T. A.A new and sensitive method for quantifying and comparing the biological potency of various estrogens in man. Acta Obstetrica & Gynecologica Scandinavica, 1979, 58, 527–30.CrossRefGoogle ScholarPubMed
3.Hedlund, P. O., Gustafsson, H., & Sjögren, S.Cardiovascular complications to treatment of prostate cancer with estramustine phosphate (Estracyt) or conventional estrogen. Scandinavian Journal of Urology and Nephrology, 1980, 55(Suppl.), 103–05.Google ScholarPubMed
4.Henriksson, P., Blomback, M., Bratt, G., et al. Activators and inhibitors of coagulation and fibrinolysis in patients with prostatic cancer treated with estrogen or orchidectomy. Thrombosis Research, 1986, 44, 783–91.CrossRefGoogle ScholarPubMed
5.Henriksson, P., Blombäck, M., Bratt, G., et al. Effects of estrogen therapy and orchidectomy on coagulation and prostanoid synthesis in patients with prostatic cancer. Medical Oncology and Tumor Pharmacotherapy, 1989, 6, 219–25.CrossRefGoogle ScholarPubMed
6.Henriksson, P., Blombäck, M., Eriksson, A., et al. Effects of parenteral estrogen on the coagulation system in patients with prostatic carcinoma. British Journal of Urology, 1990, 65, 282–85.CrossRefGoogle ScholarPubMed
7.Henriksson, P., & Edhag, O.Orchidectomy versus estrogen in patients with prostatic cancer: Cardiovascular effects. British Medical Journal, 1986, 293, 513–15.Google ScholarPubMed
8.Henriksson, P., & Edhag, O.Cost-effectiveness comparison of estrogen therapy and orchidectomy in patients with prostatic cancer. International Journal of Technology Assessment in Health Care, 1987, 3, 523–29.CrossRefGoogle ScholarPubMed
9.Henriksson, P., Eriksson, A., Stege, R., et al. Cardiovascular follow-up of patients with prostatic cancer treated with single-drug polyestradiol phosphate. The Prostate, 1988, 13, 257–61.CrossRefGoogle ScholarPubMed
10.Huggins, C., & Hodges, D. V.Studies on prostatic cancer. I. The effect of castration, of estrogen and of androgen injection on serum phosphatases in metastatic carcinoma of the prostate. Cancer Research, 1941, 1, 293–97.Google Scholar
11.Huggins, C., Scott, W. W., & Hodges, C. V.Studies on prostatic cancer. III. The effects of fever, of desoxycorticosterone and of estrogen on clinical patients with metastatic carcinoma of the prostate. Journal of Urology, 1941, 46, 997–1006.CrossRefGoogle Scholar
12.Huggins, C., Stevens, R. E. Jr., & Hodges, C. V.Studies on prostatic cancer. II. The effects of castration in advanced carcinoma of the prostate gland. Archives of Surgery, 1941, 43, 209–23.CrossRefGoogle Scholar
13.Stege, R., Carlstrom, K., Collste, L., et al. Single-drug parenteral estrogen treatment in prostatic cancer: A study of two maintenance-dose regimens. The Prostate, 1989, 14, 183–88.CrossRefGoogle ScholarPubMed
14.Veterans Administration's Cooperative Urological Research Group. Carcinoma of the prostate: Treatment comparison. Journal of Urology, 1967, 98, 516–22.CrossRefGoogle Scholar
15.von Schoultz, B., Carlstrom, K., Collste, L., et al. Estrogen therapy and liver function — metabolic effects of oral and parenteral administration. The Prostate, 1989, 14, 389–95.CrossRefGoogle ScholarPubMed
16.Weinstein, M. C., & Stason, W. B.Foundations of cost-effectiveness analysis for health and medical practices. New England Journal of Medicine, 1977, 296, 716–21.CrossRefGoogle ScholarPubMed