Comparison between surgical and medical castration in advanced prostate cancer management

Abstract EN

Objective: This prospective, retrospective study was performed to determine the importance of surgical castration as a more effective method than hormonal castration in androgens blockage of patients diagnosed with advanced prostate cancer.

Methods: This randomized clinical trial was carried out between 2013 and 2015 on 50 patients who were referred to the Urology Clinic and Oncology Clinic of Aleppo University Hospital and diagnosed with advanced prostate cancer established by clinical, imaging, laboratory and pathological features.

A surgical castration (simple orchiectomy) has been done for a sample of patients and the others has been treated by medical castration, then a comparison between the two samples has been done according to Prostate-Specific Antigen (PSA) levels after 3 months and after one year of treatment.

After that, the parameters were assessed and data collected was analyzed using Chi-square χ2 test, p-value<0.05 was considered statistically significant.

Results: On average, efficacy of both types of castration were approximate after 3 months of treatment, whereas the treatment considered effective if PSA level was less than 4 ng/ml.

A percentage of surgical patients castration with PSA less than 4 ng/ml was 69.23% whereas the percentage of patients with medical castration was 70.83%.

PSA levels has been measured after one year of treatment in both groups and the percentage of surgical patients castration with PSA less than 4 ng/ml was 80.76% whereas percentage of patients with medical castration has been falled to 62.5%.

This falling happened because some patients didn’t complete their doses of anti-androgens medications or because of side effects of these medications.

Side effects of anti-androgen medication has been appeared in 75% of medical castration patients, whereas psychological effect has been appeared in 69.23% of patients with simple orchiectomy.

Conclusions: Surgical castration is better than medical castration in treatment of advanced prostate cancer according to cost effective, safety, and availability