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. 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.

The physician suggested that the man’s testosterone levels be lowered. He suggested castration; however, the man was not interested in castration and asked if there was another way to treat this. He was treated was 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 man? How do you know?

2. How would this man’s disorder have affected his urinary and reproductive abilities?

3. Describe a mechanism by which a drug could lower the testosterone level in the human body.

4. Why would castration reduce testosterone? Would all of a castrated man’s testosterone be gone? Why or why not?

5. How would castration affect a man’s ability to have an erection or ejaculate? Why?