Relationship of Serum Acid Phosphatase Determination to Presence of Bone Metastases from Carcinoma of Prostate

Herger, Charles C.; Sauer, Hans R.; Simpson, Burton T.

doi:10.1016/s0022-5347(17)70918-4

Cited by 13 publications

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“…Although castration was previously suggested and occasionally used as a treatment for cancer of the prostate, it was not until the excellent work of Huggins and his group109, no on the effect of the hormones on the prostate and that of the Gutmans182 on acid phosphatase that investigation of the hormonal relation to the disease received a real stimulus. The prostate in childhood contains small amounts of acid phosphatase, but the level rises considerably after puberty.183 This enzyme, which is present apparently in large amounts only in the prostate, The New England Journal of Medicine seems to be directly related to the secretory activity of the gland.184 Serum-acid phosphatase levels are frequently elevated in patients with cancer of the prostate, particularly those with bone métastases.182' [186][187] Serum-alkaline phosphatase levels are also above normal in many cases in which osseous métastases are part of the clinical picture.182 Excessive acid phosphatase can be demonstrated by histologie examination of neoplastic prostatic tissue. 188 Dean, Woodard and Twombly189 state that patients may be placed in four groups, based on the serum-phosphatase levels:…”

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Endocrine Aspects of Cancer

Nathanson¹

1944

N Engl J Med

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Clinical ObservationsTumors of Breast Carcinoma of breast. The peak of age incidence in 2165 cases of cancer of the breast at the onset was about forty-seven years.122 The median age was fifty-two years, that is, as many cases occurred before that age as after it. Approximately a third of the patients were under forty-five years of age, another third from forty-five to fifty-five, and the remainder older than fifty-five. Taylor1'-3 found that about one third of the cases occurred during the period of mature ovarian function, another third appeared five years before and after the menopause and the remainder in women whose ovarian function had ceased five years or more.Thus, the two studies are in agreement but it must be pointed out that susceptibility to cancer of the breast steadily increases with age.122 Further data on the relation of breast cancer to the menopause were supplied by Olch.124 According to his studies 72 per cent of normal women pass through the menopause from forty to fifty years of age, whereas 55 per cent of those with cancer are still menstruating at the age of fifty. It was concluded that almost five times as many women with breast cancer had a delayed menopause as compared with normal women.Data on the length of the menopause are not readily available. This may be of importance for, even though amenorrhea is one of the primary signs of the climacteric, the ovary may continue to be active and secrete estrogens for a relatively long period.125 Since corpus-luteum function is usually diminished or absent during the menopausal years, the normal cyclic change disappears and estrogen stimulation may continue unopposed. Cancer of the breast may appear many years after castration, even when the latter has been performed at an early age. Estrogens presumably of adrenal origin are still recovered from the urine of patients who have been castrated, as well as from the urine of postmenopausal women.125 Herrell126 reviewed the records of a large number of patients in the same age group with and without cancer of the breast. The findings disclosed that in the cancer group the incidence of complete ovariectomy before the tumor appeared was 1.5 per cent. The incidence in the noncancer group was 15.4 per cent, or ten times as great.It is not known whether women who develop breast cancer have a higher percentage of menstrual disturbances than those who are free of the disease.127In one study, however, it was found that the menstrual pattern changed shortly before the discovery of the disease.123 So far as can be determined there is no gross effect of the menstrual cycle on the primary tumor. The rapidity of growth of the primary . tumor during pregnancy128 and the appearance of a tumor in the second breast during another pregnancy,129 which may ensue subsequent to treatment of the first lesion, is well recognized. Changes during lactation are usually more striking.128 Whether these effects are caused by hormones elaborated in pregnancy or lactation or to the generalized metabolic changes has not been establ...

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