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CancerThe carcinogenic process can be modulated, as new treatments unfold. This section presents varied studies, demonstrating the pros and cons of hormone modulation, supplementation, obesity and other lifestyle issues that may be therapeutically exploited. Review current research and medical articles on cancer and its response or relationship to these factors. Prostate Cancer and the Testosterone ‘Myth’.pdf
In this interview, Abraham Morgentaler, M.D.
concludes his comments saying that
“testosterone treatment can be enormously
helpful for many men. Attitudes are shifting
with regard to its relationship to prostate
cancer.” He references his article on the
subject that appeared in European Urology
in 2006. Mortality Greater for Hip Fracture Than Breast Cancer in Elderly Women.pdf
Older women are at greater risk for death
after hip fracture than after breast cancer,
according to a presentation at the American
Geriatrics Society (AGS) annual meeting held
in Seattle, Washington. The investigators
suggest that increased awareness of
mortality associated with hip fracture is
needed to improve preventive measures. Calcium and Vitamin D Intake and Risk of Colorectal Cancer - The Multiethnic Cohort Study.pdf
The associations of intakes of calcium and
vitamin D with colorectal cancer risk were
examined in the Multiethnic Cohort Study
(Hawaii and Los Angeles, California). In
1993-1996, 85,903 men and 105,108 women aged
> or =45 years completed a quantitative food
frequency questionnaire. The findings
support the hypothesis of protective roles
for calcium, vitamin D, and dairy products
in the risk of colorectal cancer. Fiber Crucial to Breast Health in Premenopausal Women.pdf
According to this article, researchers
suggest that fiber may support health in
premenopausal women because antioxidant
nutrients in high-fiber foods have
protective properties against reactive
oxygen species. Another theory, they
suggested, is that fiber may stabilize
insulin levels in the body, since
hyperglycemia may be a potential cause of
cancer. Another theory why fiber may be
important to breast health, they suggested,
revolves around estrogen’s role in the
development of breast cancer. Combination Hormone Replacement Therapy Linked to Lower-Risk Breast Cancers.pdf
The types of breast tumors that occur after
combination hormone replacement therapy in
the peri- and post-menopausal period tend to
have a better prognosis than those that
occur after estrogen-only replacement
therapy, Swedish researchers report. Neoadjuvant Mitoxantrone and Docetaxel for High-Risk Localized Prostate Cancer.pdf This study
concluded that administration of multi-agent
chemotherapy before prostatectomy was safe
in this population. This regimen appeared to
have antineoplastic activity as evidenced by
PSA reductions in the absence of significant
testosterone changes. The benefit of
chemotherapy for improving surgical margin
rates could not be determined outside of a
phase III trial because the effect of
patient or surgeon factors could not be
dissected from the potential effect of
neoadjuvant therapy. Does Growth Hormone Cause Cancer?.pdf This study
concluded that even if GH/IGF-1 therapy does
result in a small increase in cancer risk
compared to untreated patients with GH
deficiency, it is likely that the eventual
risk will be the same as the general
population. Such a restoration to normality
will need to be balanced against the known
morbidity of untreated GH deficiency. This study
concluded that serum TT, SHBG, DHEAS and ADT
levels are significantly lower in Arab men
compared to those reported for Caucasian
men, especially in early adulthood. Arab men
with newly diagnosed prostate cancer have
higher circulating androgens compared to
healthy controls. We suggest that low
circulating androgens and their adrenal
precursors in Arab men when compared to
Caucasians may partially account for the
relatively lower risk for prostate cancer
among Arab men.
Low Serum Testosterone and Mortality in Male
Veterans.pdf According
to this study, consistent with the elevation
in risk for endogenous testosterone levels,
women using estrogen and testosterone
therapies have a significantly increased
risk of invasive breast cancer.
Prostate Carcinoma Incidence in Relation to
Prediagnostic Circulating Levels of
Insulin-Like Growth Factor I, Insulin-Like
Growth Factor Binding Protein 3, and
Insulin.pdf
Researchers have reported that cancer
patients who took high-dose vitamin E
supplements to protect themselves from a
recurrence of the disease were actually at
higher risk of getting a second cancer while
taking the supplement than those in a
placebo group. Prostatic Specific Antigen in Patients with Hypogonadism: Effect of Testosterone Replacement.pdf The
current study demonstrated that the level of
PSA was not significantly changed after 1
year of testosterone replacement therapy in
patients with hypogonadism associated with
ED. The
findings of this study validate the
importance for a role
of obesity in prostate cancer
progression and suggest a link
to the biological basis of
prostate cancer progression that
can be therapeutically
exploited. Hormone Replacement, the Male Version.pdf
According to this article, a growing number
of men in the United States are now taking
testosterone to reverse the gradual,
age-related decline of the hormone, or
so-called andropause. By some estimates, the
number of testosterone prescriptions in the
United States has tripled in recent years,
and total sales now come to about $400
million a year. That’s not much compared
with the $12.5 billion spent on
cholesterol-lowering statins, but the upward
trend is still impressive. The Women’s Health Initiative 2004 – Review and Critique.pdf This
article reviews the published results from
the Women’s Health Initiative (WHI) and
their various interpretations. The WHI was
designed to define the risks and benefits of
interventions, notably hormone therapy, to
potentially prevent heart disease, breast
and colorectal cancer, and osteoporotic
fractures in postmenopausal women. Androgen Replacement After Curative Radical Prostatectomy for Prostate Cancer in Hypogonadal Men.pdf According
to this study, based on the clinical
experience with this small group of men, and
indirect evidence of the safety of this
approach from epidemiological and clinical
data, further cautious use of testosterone
in a carefully selected population seems
warranted.
Potential Anabolic Effects of Androgens on Bone.pdf With the
decrease of estrogen at menopause, the need
for androgens increases in post-menopausal
women. Androgens also appear to be
important for the bone health of women who
are pre-menopausal.
Review
of the Book The Sexy Years: Discover the
Hormone Connection: The Secret to Fabulous
Sex, Great Health, and Vitality, for Women
and Men.pdf
According to this
study, hypogonadism affects an estimated 2
million to 4 million men in the United
States; its prevalence increases with age.
However, it has been estimated that only 5
percent of affected men currently receive
treatment. Recent interest in testosterone
therapy has been fueled not only by
increased medical awareness of the effects
of hypogonadism, but also by media attention
regarding hormone-replacement therapy in
both men and women, the marketing of new
topical testosterone formulations, and the
desire of "baby boomers" to maintain vigor
and health into their more mature years. The aim of
this study was to investigate whether
different treatment regimens or the
androgenecity of progestins influence the
risk of breast cancer differently. In this
study, no support was found for the
hypothesis that high levels of circulating
androgens within a physiologic range
stimulate development and growth of prostate
cancer.
Growth Hormone Replacement Therapy Appears
Safe in Long Term.pdf This
randomized trial suggests that continuous
combined estrogen plus progestin therapy may
increase the risk of ovarian cancer while
producing endometrial cancer rates similar
to placebo. The increased burden of
endometrial biopsies required to assess
vaginal bleeding further limits the
acceptability of this regimen. These data
provide additional support for caution in
the use of continuous combined hormones. In this
study, the inverse association between E2
and prostate cancer risk was largely
restricted to men with blood collection
within 3 years of diagnosis. The results add
to the evidence that serum testosterone is
unrelated to prostate cancer incidence. The
suggestions that intraprostatic androgen
activity may increase risk and that serum
estrogens may decrease risk, warrant
additional study. This study
concluded that relatively short-term
combined estrogen plus progestin use
increases incident breast cancers, which are
diagnosed at a more advanced stage compared
with placebo use, and also substantially
increases the percentage of women with
abnormal mammograms. These results suggest
estrogen plus progestin may stimulate breast
cancer growth and hinder breast cancer
diagnosis. Insulin Resistance and Prostate Cancer Risk.pdf In this
study, the associations between prostate
cancer risk and insulin sensitivity or
resistance were independent of total caloric
intake and serum levels of insulin-like
growth factors, sex hormones, and sex
hormone-binding globulin. Because of the
retrospective design of this study, the role
of insulin resistance in prostate cancer
needs to be confirmed in prospective
studies. Growth Hormone Protects Human Lymphocytes from Irradiation-Induced Cell Death.pdf According
to this study, undesired effects of cancer
radiotherapy mainly affect the hematopoietic
system. Growth hormone (GH) participates in
both hematopoiesis and modulation of the
immune response. This study
concludes that pretreatment total
testosterone was an independent predictor of
extraprostatic disease in patients with
localized prostate cancer. As testosterone
decreases patients have an increased
likelihood of non-organ confined disease.
Low testosterone was not predictive of
biochemical recurrence, although trends
observed dictate study in larger cohorts
with mature followup.
Testosterone Replacement Therapy in
Hypogonadal Men at High Risk for Prostate
Cancer: Results of 1 year of Treatment in
Men with Prostatic Intraepithelial
Neoplasia.pdf Prostate Cancer and Prostate-Specific Antigen: The More We Know, the Less We Understand.pdf This
editorial discusses PSA and in particular
the Cramer et al study that observes that
PSA values may be
related to polymorphisms in the PSA gene
promoter. Overweight, Obesity, and Cancer Risk.pdf According
to this article, in addition to an increase
in the risk of cardiovascular disease and
type II diabetes, the evidence summarized
here shows that excess body weight is
directly associated with risk of cancer at
several organ sites, including colon, breast
(in postmenopausal women), endometrium,
oesophagus, and kidney. This study
suggests that GH replacement therapy is safe
and efficacious for the correction of GH
deficiency in survivors of childhood acute
lymphoblastic leukemia (ALL). Bone Loss Following Hypogonadism in Men with Prostate Cancer Treated with GnRH Analogs.pdf These
findings of this study demonstrate a
significant loss of bone in men with
prostate cancer after receiving GnRH therapy
and suggest that the total hip and radius
are the preferred sites for monitoring bone
loss in older men. In addition, markers of
bone resorption may be helpful. This
article proposes that, as in patients with
hypopituitarism caused by pituitary disease,
the main indication for GH replacement in GH-deficient
survivors of childhood cancer should be
severe impairment of quality of life.
This study
concludes that GH therapy does not appear to
increase the risk of disease recurrence or
death in survivors of childhood cancer. The
increased number of SN, particularly in
survivors of acute leukemia, is of concern,
but the data need to be interpreted with
caution given the small number of events.
Changes in Body Composition During Androgen Deprivation Therapy for Prostate Cancer.pdf The aim of
this study was to determine the effects of
initial treatment with a GnRH agonist on
body composition in asymptomatic men with
nonmetastatic prostate cancer. Growth Hormone Treatment and Neoplasia-Coincidence or Consequence?.pdf This
special editorial by the Lawson Wilkins
Pediatric Endocrine Society (LWPES) Writing
Committee discusses the article by Swerdlow
et al in Lancet, which reports on the
risk of cancer in patients treated with
human pituitary GH in the United Kingdom
from 1959 to 1985. The
interpretation of this study is that
although based on small numbers, the risk of
colorectal cancer is of some concern and
further investigation in other cohorts is
needed. They have no evidence as to whether
growth hormone in modern dosage regimens is
associated with an increased risk of
colorectal cancer.
Association Between Prostate Cancer and Serum Testosterone Levels.pdf The
findings of this study show that serum total
and free testosterone levels in patients
with prostate cancer are altered, supporting
the possibility that prostate cancer may
inhibit serum testosterone levels. Prostate Cancer Risk and Serum Levels of Insulin and Leptin: A Population-Based Study.pdf The
results of this study suggest that serum
insulin levels may influence the risk of
prostate cancer in Chinese men. Further
research, especially prospective studies, is
needed to confirm these findings in
high-risk populations and to clarify the
underlying mechanisms involved. Clinical Perspective - Acromegaly and Cancer: Not a Problem?.pdf
This study discusses
how uncontrolled acromegaly may provide a
growth advantage to concurrently occurring
neoplasms in these patients; and based upon
experimental information, cancer in a
patient with acromegaly and uncontrolled GH
levels will likely be more aggressive, with
potentially increased cancer-associated
morbidity and mortality. However, there is
no clear evidence for enhanced de novo
cancer initiation in acromegaly and, as yet,
no direct proven causal relationship of
acromegaly with malignant disease. Low Serum Insulin-Like Growth Factor 1 (IGF-1): A Significant Association with Prostate Cancer.pdf According
to this study, insulin-like growth factor 1
(IGF-1) is an important mitogenic and
antiapoptotic peptide that affects the
proliferation of normal and malignant cells.
Findings of this study indicate a
significant association between low serum
levels of IGF-1 and prostate cancer. According
to this study, in screen-positive men with
elevated serum PSA, serum IGF-I is not a
useful diagnostic test for prostate cancer,
but it may be associated with benign
prostatic hyperplasia and enlargement. This study
concluded that there was no significant
association between IGF-1 serum levels and
prostate cancer. Short-term androgen
withdrawal using LHRH analogues combined
with anti-androgens had no effect on the
levels of IGF-1. The Prevalence and Characteristics of Colorectal Neoplasia in Acromegaly.pdf In this
study, no associations were found between
the presence of colonic neoplasia and the
duration of disease, total GH exposure, cure
status, and serum insulin-like growth factor
I. This study has failed to demonstrate an
increased prevalence of neoplasia in
acromegalic patients compared with the
expected prevalence in the general
population and questions the need for an
aggressive colonoscopic screening policy. This study
provides strong evidence that the addition
of a progestin to HRT enhances markedly the
risk of breast cancer relative to estrogen
use alone. These findings have important
implications for the risk-benefit equation
for HRT in women using CHRT. The
present study confirms short-term data
published in the literature on a sex
difference in rhGH dose requirement in GH-deficient
patients. It furthers extends the data by
demonstrating that this sex difference in GH
responsivity persists and changes during the
24 months of the study. Moreover, it shows
that estrogen replacement blunts the IGF-I
response to rhGH in women, whereas in men
with androgen substitution the responsivity
increases over time, thus bearing a risk of
undertreatment in women and overtreatment in
men. According
to this article, two observations support
the view that the prostate cancer risks from
use of testosterone hormone replacement may
not be as great as first feared. Firstly,
prostate cancers arising in men with low
serum testosterone levels are more malignant
and frequently nonresponsive to hormones.
Secondly, breast cancers diagnosed in women
on HRT though increased in number are less
malignant possibly because of enhanced
sensitivity to hormone therapy, and the
situation may prove to be analogous with
prostate cancer and testosterone
replacement. According
to this study, the results demonstrate no
evidence for an increased risk of tumor
recurrence after rhGH treatment for a short
period of time after removal of a
gastrointestinal adenocarcinoma. Therefore,
the positive metabolic effects of rhGH
application can be used safely in the
treatment of the postoperative catabolic
state in the patient groups investigated. According
to this study, the insulin-like growth
factors (IGFs) are mitogens that play a
pivotal role in regulating cell
proliferation, differentiation, and
apoptosis. The effects of IGFs are mediated
through the IGF-I receptor, which is also
involved in cell transformation induced by
tumor virus proteins and oncogene products. The aim of
this study was to investigate the impact of
growth hormone, alone and in combination
with insulin, on the protein kinetics of
patients with upper gastrointestinal (GI)
tract cancer who have undergone surgery and
are receiving total parenteral nutrition (TPN).
It concluded that growth hormone and GH plus
insulin regimens improve protein kinetic
parameters in patients with upper GI tract
cancer who are receiving TPN after
undergoing surgery. According
to this study, for men with low lycopene,
beta-carotene supplements were associated
with risk reductions comparable to those
observed with high lycopene. These data
provide further evidence that increased
consumption of tomato products and other
lycopene-containing foods might reduce the
occurrence or progression of prostate
cancer. Hormone Replacement Therapy and Breast Cancer Risk in a Nationally Representative Cohort.pdf This
study, based on a nationally representative
cohort followed for up to 22 years, failed
to find an increased risk of breast cancer
associated with the use of HRT. It provides
further evidence that if there is an
increased risk of breast cancer associated
with HRT use, this risk is small. The
findings of this study suggest that
circulating IGF-I and IGFBP-3 are related to
future risk of colorectal cancer.
Hormone Replacement Therapy and the Risk of Colorectal Cancer: A Meta-Analysis.pdf This
article concludes that the risk of colon
cancer may be decreased among recent
postmenopausal HRT users. Although data are
limited, the risk of fatal colon cancer also
may be lower in HRT users. Hormone Replacement Therapy and Risk of Colon and Rectal Cancer.pdf This
study, one of the largest case-control
investigations on exogenous female hormones
and colorectal cancer thus far, provides
further evidence that women who have ever
used HRT are at lower risk of colon and
rectal cancer. Because colorectal cancer is
the second most common neoplasm and cause of
death among nonsmoking women in developed
countries, these results may have a major
public health impact.
In
long-term (21 day) experiments, BP treatment
induced a 145.3% increase (P=0.001) in
anchorage-dependent colony formation. This
aberrant proliferation was inhibited by
44.2% to 65.3% (P=0.01) in the presence of
the three phytochemicals. Thus, BP-induced
aberrant proliferation is inhibited by the
natural phytochemicals in part due to
regulation of cell cycle progression and
induction of p53 dependent apoptosis. The
interpretation of this study was that the
risk of having breast cancer diagnosed is
increased in women using HRT and increases
with increasing duration of use. This effect
is reduced after cessation of use of HRT and
has largely, if not wholly, disappeared
after about 5 years. These findings should
be considered in the context of the benefits
and other risks associated with the use of
HRT. The data
in this study suggest that HRT use in women
with a family history of breast cancer is
not associated with a significantly
increased incidence of breast cancer but is
associated with a significantly reduced
total mortality rate. This study
says that the preventive efficacy of I3C on
human mammary carcinogenesis may be due in
part to its ability to regulate cell-cycle
progression, increase the formation of
antiproliferative E2 metabolite, and induce
cellular apoptosis. Hormone Replacement Therapy and Endometrial Cancer Risk: A Meta-Analysis.pdf This study
concluded that endometrial cancer risk
increases substantially with long duration
of unopposed estrogen use, and this
increased risk persists for several years
after discontinuation of estrogen. Although
not statistically significant, the risk of
death from endometrial cancer among
unopposed estrogen users is increased,
similar to the increased risk of developing
the disease. Data regarding risk for
endometrial cancer among estrogen plus
progestin users are limited and conflicting. Evidence of a Healthy Estrogen User Survivor Effect.pdf This article examined the relation between menopausal estrogen use and all-cause and cause-specific mortality in a cohort of over 49,000 women followed between 1979 and 1989 in the Breast Cancer Detection Demonstration Project (BCDDP) Follow-Up Study,Sturgeon, S.R., Schairer, C., Brinton, L.A., Pearson, T., & Hoover, R.N. (1995). Evidence of a healthy estrogen user survivor effect [Electronic version]. Epidemiology, 6(3), 227-231. Retrieved October 3, 2005.
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