 |
|
Prostate Function Other prostate function studies are surfacing throughout the medical literature, establishing the following facts. Obesity plays a role in prostate cancer progression potentially linking to its biological basis—which opens up possibilities for potential therapy. As we know, obesity plays a role in the initiation and progression of cancer in general. Studies now prove that cancer is not related to testosterone therapy; in fact, the opposite is true. The men who get prostate cancer have low testosterone and high estrogen. There are also studies now revealing the lack of testosterone replacement therapy in prostate cancer patients is showing an earlier mortality due to cardiovascular disease. A landmark article just published last year by the American Cancer Society shows a reduction in the risk of prostate cancer with higher IGF-BP3 levels, listed for your perusal. Review current research and medical articles on prostate function to better help your male patients. 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. Male Menopause Out of the Closet.pdf
According to this
article, as men age,
their testosterone
levels gradually
decline and some men
go through what is
now called male
menopause. But many
never get diagnosed
or treated because
until now male
menopause has been
in the closet. 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.
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
This study used a
clinical database to
identify men older
than 40 years with
repeated
testosterone levels
obtained from
October 1, 1994 to
December 31, 1999,
and without
diagnosed prostate
cancer. It
concluded that low
testosterone levels
were associated with
increased mortality
in male veterans.
Further prospective
studies are needed
to examine the
association between
low testosterone
levels and
mortality.
In this study,
the IGF-1 level was
not associated
positively with the
risk of prostate
carcinoma; however,
an increase in the
IGFBP-3 level was
associated with a
modest decrease in
risk. 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. 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 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. Androgen Replacement in Men with Hypogonadism and Erectile Dysfunction.pdf
This paper
concludes that
therapy should be
individualized,
considered
carefully, and
closely monitored
because of potential
risks, especially in
older men.
The results of
this study
demonstrate that T
therapy in older men
with low serum T
increases vertebral
and hip BMD over 36
months, both when
administered alone
and when combined
with F. This finding
suggests that
dihydrotestosterone
is not essential for
the beneficial
effects of T on BMD
in men. In addition,
the concomitant
administration of F
with T appears to
attenuate the impact
of T therapy on
prostate size and
PSA and might reduce
the chance of benign
prostatic
hypertrophy or other
prostate-related
complications in
older men on T
therapy. These
findings have
important
implications for the
prevention and
treatment of
osteoporosis in
older men with low T
levels. 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.
High Levels of Circulating Testosterone Are Not Associated with Increased Prostate Cancer Risk: A Pooled Prospective Study.pdf
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. Reduced Longevity in Untreated Patients with Isolated Growth Hormone Deficiency.pdf
The aim of this
study was to analyze
the impact of
untreated GHD on
life span.
Hereditary dwarfism
was recognized in 11
subjects.
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. 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.
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.
This study
concludes that after
1 year of
testosterone
replacement therapy
(TRT) men with
prostatic
intraepithelial
neoplasia (PIN) do
not have a greater
increase in PSA or a
significantly
increased risk of
cancer than men
without PIN. These
results indicate
that TRT is not
contraindicated in
men with a history
of PIN.
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. Long-Term Effects of Androgen Deprivation Therapy in Prostate Cancer Patients.pdf
This study
suggests that
osteoporosis,
unfavourable body
composition, sexual
dysfunction and
reduced quality of
life are seen in
patients receiving
androgen deprivation
therapy for at least
12 months.
Longitudinal studies
in this patient
population will shed
further light on the
timing of the
development and the
extent of these
complications.
Meanwhile, this
information will
assist both
physicians and
patients with
prostate cancer to
make informed
decisions regarding
androgen deprivation
therapy. 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. 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. 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.
From the results
of this study, the
authors conclude
that I3C inhibits
the growth of PC-3
prostate cancer
cells by inducing G1
cell cycle arrest
leading to
apoptosis, and
regulates the
expression of
apoptosis-related
genes. These
findings suggest
that I3C may be an
effective
chemopreventive or
therapeutic agent
against prostate
cancer. 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.
In this study’s
population of
elderly men, no
racial differences
in androgen levels
were found. Androgen
levels did not
correlate with PSA
levels in prostate
cancer patients. 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. Is Low Serum Free Testosterone a Marker for High Grade Prostate Cancer?.pdf
In this study,
patients with
prostate cancer and
low free
testosterone had
more extensive
disease. In
addition, all men
with a biopsy
Gleason score of 8
or greater had low
serum free
testosterone. This
finding suggests
that low serum free
testosterone may be
a marker for more
aggressive disease.
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. Testosterone Replacement and the Physiologic Aspects of Aging in Men.pdf
The focus of the
clinical
investigations
described here is to
determine whether
testosterone
deficiency is a
physiologic cause of
the aging process
and whether
testosterone
replacement might
prevent or
ameliorate a decline
in quality of life
associated with
age-related decline
in physical and
psychological
functioning.
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. Experience with Testosterone Replacement in the Elderly.pdf
According to this
discussion, to date,
most of the studies
of androgen
replacement have
been done with
healthy older men
(age > or = 55
years), and almost
no data are
available for frail
elderly individuals.
Treatment effects
that make a
relatively small
difference in
younger, more robust
individuals may have
a greater effect on
the elderly, whose
improvement in
functioning and
level of activity
may be more
dramatic.
This study
concludes that
chronic excess of GH
and IGF-I cause
prostate overgrowth
and further
phenomena of
rearrangement, but
not prostate cancer.
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.
According to this
study, despite
significant
elevations in serum
total and free
testosterone,
healthy young men do
not demonstrate
increased serum or
semen PSA levels, or
increased prostate
volume in response
to exogenous
testosterone
injections.
This study
concluded that
testosterone
replacement therapy
appears to be well
tolerated by over
84% of the subjects.
Long term
testosterone
replacement to date
appears to be a safe
and effective means
of treating
hypogonadal elderly
males, provided that
frequent follow-up
blood tests and
examinations are
performed.
|
