Further Observation on Serum Acid Phosphatase Activity in Carcinoma of the Prostate

During the past three ,years serum acid and alkaline phosphatase deterlninations have been carried out by Barringer and Woodard (z) , Gutman and Gutman and their co-workers (2-4, io ) , Huggins (7-9), ctc., as a means of facilitating early rccognition of metastatic bone lcsions from carcinoma of the prostate. In recent publications (5, 6) we have pointed out that, in our opinion, serum acid phosphatase values up to 4.o King-Armstrong units per too cc. of blood serum should be considered normal. Valucs of from 4.0 to 6.0 units reprcsent borderline figures which havc no apprcciable diagnostic iInportancc providcd no further increase of the phosphatase level takes place on subsequent determinations. A considerable elevation of the serum acid phosphatase is always indicative of metastatic bone involvement from carcinoma of the prostate, and repeated determinations in thcsc cascs have shown that there is a definite tendency of the serum acid phosphatase activity to increase as the disease progresses. Recent reports by Huggins and his co-workers (7-9) indicate that bilateral orchidectolny ,nay result in appreciable improvement in cases of prostatic cancer cvcn if demonstrable mctastascs to the boncs arc prcscnt. This improvement coincides with gain in wcight, incrcasc in the rcd blood count, regression in sizc and softening of the consistency of the prostate, and dccrcase of the serum acid phosphatase activity. Favorable results were also obtained by Huggins and his co-workers if the patients received stilbestrol medication.