Circulating steroid hormone variations throughout different stages of prostate cancer

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   Figure 1

   Overview of steroidogenesis leading to the production of androgens, estrogens, mineralocorticoids and glucocorticoids. The classical pathway produces DHT through conversion of DHEA, androstenedione and testosterone. The backdoor pathway of DHT synthesis completely bypasses canonical androgen synthesis and instead involves 5α-reduced conversion products ultimately leading to the production of androsterone or androstanediol as precursors for DHT. An alternative pathway produces DHT with androstanedione as intermediary rather than testosterone. Black arrows depict conversions steps with the responsible enzymes listed in red. The 11-oxygenated androgen synthesis pathway is listed, starting with the conversion of androstenedione to 11-hydroxy-androstenedione. DHEA, dehydroepiandrosterone; DHEAS, dehydroepiandrosterone-sulfate; DHT, 5α-dihydrotestosterone; DOC, deoxycorticosterone.
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   Figure 2

   Serum steroid concentrations in healthy men and patients with prostate cancer during different modalities of treatment. The symbols depict the median of reported values from literature. A complete overview of papers reporting serum values for these steroids is available in Supplementary Table 1. Interquartile range data are presented when a full circle symbol is used. A semi-full circle depicts 95% confidence interval data. An open circle depicts range data. A semi-full diamond depicts a range of mean values from literature. Values from the recent McKay et al. (2017) study are listed independently because they achieved lower limits of quantification than other studies. *levels at or below the lower limit of quantification in the original study. The y-axis steroid values are spaced logarithmically. ADT, androgen deprivation therapy; BPH, benign prostatic hyperplasia; CRPC, castration-resistant prostate cancer; DHEA, dehydroepiandrosterone; DHEAS, dehydroepiandrosterone-sulfate; DHT, 5α-dihydrotestosterone.

• © 2017 Society for Endocrinology