Think these guys are worried?
Posted on 08/16/2005 5:00:42 AM PDT by truthandlife
Prostate cancer developed in 20 men within months to a few years after they began testosterone supplementation to correct a deficiency of the hormone, investigators report.
"There are several anecdotal case reports, small studies, and observational studies like ours which raise concern but do not provide conclusive evidence yet," Dr. Franklin D. Gaylis told Reuters Health.
The issue is a concern because prostate cancer is usually driven by testosterone.
Gaylis, from the University of California at San Diego Medical Center, and colleagues report this series of patients "in whom clinically significant prostate cancer developed and was presumed to be related to exogenous testosterone use," in the Journal of Urology.
The men were identified in six different urology practices. Prostate cancer was detected within 2 years of the start of testosterone replacement in 11 of these men, seven of them within the first year, the authors report. The others were diagnosed after 28 months to 8 years.
Eleven men had normal prostate exams before testosterone supplementation was begun, the report indicates, and the average PSA level of the 17 men tested before treatment was 3, although the range was 0.9 to 15. The threshold for further evaluation is usually 4.
"It is our belief that men, especially those with a family history of prostate cancer, should not receive a prescription for testosterone supplementation without careful, informed consultation regarding the risks and benefits of such treatment," the investigators conclude.
"I would hope that guidelines would be developed by experts in the field to help us appropriately and carefully prescribe testosterone replacement to men who clearly need it and who would benefit from it, and then monitor them for potential adverse outcomes, e.g., the development of prostate cancer," Gaylis said.
While the study has flaws, writes Dr. E. Darracott Vaughan, Jr. from Weill Medical College of Cornell University, New York, in a related editorial, it "can be taken as a 'shot across the bow' for urologists and other physicians. We need to be extremely careful before beginning testosterone therapy."
SOURCE: Journal of Urology, August 2005.
Think these guys are worried?
Well, John Kerry probably better get tested then!
Remember, this is a pretty small study. The unfortunate thing is that PSA tests are now are really being scrutinized for their usefulness.
See "Prostate cancer test gets another look" ( http://www.boston.com/news/globe/health_science/articles/2005/08/15/prostate_cancer_test_gets_another_look/ )
That might actually mean something if we knew what percentage of the total number of men receiving testosterone therapy this represents.
...this series of patients "in whom clinically significant prostate cancer developed and was presumed to be related to exogenous testosterone use," in the Journal of Urology.
Why not presume its related to their astrological sign?
While the study has flaws,...
Study, what study? Observing that 20 guys got prostate cancer is not a study. This is the sort of stuff my high science teacher would have rejected.
Testosterone use may speed up the development of already existing prostate cancer. If you look at the guidelines endocrinologists use for prescribing testosterone, doctors are cautioned to give a prostate exam before prescribing it and then not using it if there's any enlargement of the prostate to begin with. Not all physicians may be following these guidelines.
thanks, good read.
A good friend recently completed hormone and radiation therapy for prostate cancer. He refused all but the initial injection of testosterone-depleting hormones because he did not like the side effects. His urologist advised against his decision, but he was determined not to be chemically neutered.
Once he was diagnosed, he began trying to learn as much as he could about prostate cancer. One of the things that struck him was that many men are diagnosed at about the same time in life that their testosterone levels diminish. In his mind, there exists a correlation to this drop in testosterone and the development of prostate cancer.
He damanded testosterone therapy as soon as his radiation therapy ended. His doctors refused to even consider it, and told him it would be suicidal to think such a treatment made any sense. Not to be denied, he did a little doctor-shopping, and found an endocrinologist that now prescribes patches for his use.
He has been using the patches for just about six months with no increase in PSA, and thinks he is a born genius. He may well be a pioneer, or he may well be one crazy sucker, but he is convinced that doctors are too tied to tradition, and therefore are afraid to try radical ideas.
I suppose we'll find out.
Actually, I heard somewhere (and of course I have no idea where....maybe it as from my father's doctor....my dad had PC) that an over-abundance of testosterone is linked to prostate cancer. There must be some truth to it.
Prostate Cancer is going to be this generation's version of the hysterectomy scandals of the 90's. The ability to detect the disease has far outrun the ability to make accurate prognoses about outcomes. As a result, large numbers of men who need no treatment are being subjected to life-altering procedures. Conversely, some who might benefit from treatment are not being treated. No-one's at fault here, it just that one part of the science has outrun another part.
With other causes ruled out, PSA is a useful tool to monitor tumor load once the disease has been detected. It's just a real non-discriminatory tool for initial detection. Interestingly enough, the New Zealand national health plan has decided to stop routine PSA screening on the theory that , on balance, it does more harm than good. Not that it doesn't turn up patients with undetected cancer, but the negative impacts to those who'd have been better left untreated exceed the positive impacts of treating those who can be helped.
There's nothing about the field of Prostate Cancer that's not controversial, and until the science catches up, every man diagnosed with it (which means most men in this culture) will have to make difficult choices with almost no information.
His pioneering approach is shared by some in the medical profession. Dr. Robert Leibowitz, a Los Angeles oncologist and well-known PC maverick has been treating prostate cancer patients with testosterone for some time now. His theory is that large doses inhibit tumor growth, rather than encourage it. He's had some success with that approach, but knowledge about the disease and proper treatment protocols is definitely in the preliminary stages.
Disclaimer: Opinions posted on Free Republic are those of the individual posters and do not necessarily represent the opinion of Free Republic or its management. All materials posted herein are protected by copyright law and the exemption for fair use of copyrighted works.