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OESTROGENS FOR CARCINOMA OF THE PROSTATE

THE possibility that the administration of <estrogen to patients with carcinoma of the prostate might be doing more harm than good was suggested by a massive survey of the Veterans Administration Co-operative Urological Research Group published in 1967.1• 2 It appeared that some patients might be dying from cardiovascular disease induced by the administration of stilbcestrol. The survey was open to the criticism, however, that no assessment of cardiovascular status of patients had been made prior to the administration of <estrogen; in addition, quite large numbers of patients had been moved from one treatment group to another during the period of the survey. However, two more recent publications'v' have taken these factors into account, and there now seems little doubt that the decrease in cancer mortality associated with a dose of 5 mg of stillbcestrol to patients with Stage III and Stage IV carcinoma of the prostate is offset by an increase in deaths from cardiovascular causes. In addition to fatal cardiovascular disease there is also an increase in the incidence of non-fatal myocardial infarct, congestive heart failure associated with ischemic heart disease and cerebrovascular accident.