Surgery, endocrine response

Patients must be monitored to assess their response to treatment and to detect recurrent diseases. PSA as a specific marker for prostate cancer is most useful in monitoring patients who have been treated with radical prostatectomy, radiation therapy, or endocrine therapy. The concentration of PSA falls to undetectable levels following a radical prostatectomy because all prostate tissue has been removed. Generally, PSA is measured at periodic intervals. In studies, the extent of disease at the time of surgery correlated well with the postoperative PSA concentration. A significant measurable PSA concentration after prostatectomy indicates that residual tumor may be present. PSA concentrations decline gradually after radiation therapy (36). 

Ovarian ablation (oophorectomy) is considered by some to be the endocrine therapy of choice in premenopausal women and produces similar overall response rates as tamoxifen. Medical castration with an LHRH analog, goserelin, leuprolide, or triptorelin, is a reversible alternative to surgery. 

The metabolic response in patients undergoing total hypophysectomy or adrenalectomy (and in those undergoing surgical procedures some time after these endocrine ablation procedures) follows the characteristic course provided constant maintenance doses of cortisol are given before and after surgery. Increases above the maintenance doses are not required (J5). Constant replacement therapy does not ensure a constant... 

Faintuch, J. Horie, L.M. Barbeiro, H.V Barbeiro, D.F. Soriano, F.G. Ishida, R.K. Cecconello, I. Systemic inflammation in morbidly obese subjects Response to oral supplementation with alpha-linolenic acid. Obesity Surgery 2007, 17, 341-347. Ferrucci, L. Cherubini, A. Bandinelli, S. Bartali, B. Corsi, A. Lauretani, F. Martin, A. Andres-Lacueva, C. Senin, U. Guralnik, J.M. Relationship of plasma polyunsaturated fatty acids to circulating inflammatory markers. J Clin Endocrin Metab 2006, 91,439-436. 

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