Unit Discussion Male Reproductive 11 unread reply.11 reply. A 67-year-old retired male went to his doctor, complaining initially of leg pain that started in his lower back, which then radiated down across the side of his thigh and over the front of his knee. Subsequently, he developed pain that radiated from his back to his front at two different levels: at the chest through the level of his nipples and also at the umbilicus. His physician performed a history and physical, followed by laboratory tests. He discovered a hard nodule on his prostate and an elevation in several of the blood tests. His PSA (prostate-specific antigen), an enzyme secreted by normal prostate tissue (0-4 ng/ml) was 450. Alkaline phosphatase was also elevated at 157 U/L, an indication of bone involvement. A bone scan was ordered to visualize the bone involvement. (This test uses a calcium analog attached to a radioactive tag. A special scanner can pick up images of this radioactivity and create an anatomical picture of the skeletal system. The radiation shows up as black spots on the film.) Usually, prostate cancer′s growth is initially influenced by the presence of testosterone. If testosterone is removed by castration, cancer will often shrink for some period of time before the remaining fraction of testosterone-independent cancer cells grows. This gentleman was not interested in castration and asked if there was another way to treat this. He was treated as a single shot of a drug which is slowly released into the body over a three-month time period. Within that time the patient noticed marked relief in his pain. 1. What is the diagnosis of this gentleman? 2. Which endocrine organs are responsible for serum calcium levels? 3. Describe a mechanism by which a drug could act on the anterior pituitary to lower the testosterone level in the human body.
