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Prostate Cancer in a Transgender Woman 41 Years After Initiation of Feminization

Rebecca A. Miksad, MD; Glenn Bubley, MD; Paul Church, MD; Martin Sanda, MD; Neil Rofsky, MD; Irving Kaplan, MD; Amiel Cooper, MD
JAMA. 2006;296(19):2312-2317. doi:10.1001/jama.296.19.2316.
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Figure. Treatment Course, PSA Values, and Serum Hormone Levels for a Transgender Woman With Prostate Cancer
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Serum hormone levels were obtained prior to and at completion of treatment (estradiol was not measured at week 35). External beam radiotherapy was delivered weeks 8 to 16. The whole pelvis received 45 Gy (conventional 4-field technique). The gross tumor received an additional 27 Gy (intensity-modulated). PSA indicates prostate-specific antigen; DHEA, dehydroepiandrosterone. SI conversion factors: to convert testosterone to nmol/L, multiply by 0.0347; estradiol to pmol/L, multiply by 3.671. (Reference ranges, age-adjusted: PSA, 0-4 ng/mL; testosterone, male: 280-800 ng/dL, female, 8-82 ng/dL; DHEA, male: 51.7-295 μg/dL, female, 18.9-205 μg/dL; estradiol, male: 8-43 pg/mL, female [premenopausal], 13-211 pg/mL, female [postmenopausal], 0-55 pg/mL).

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