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--- Paul Rogers <paulr99@gmail.
> Ken,
>
> I think you assume too much if you consider that
> prostate cancer is
> primarily caused or promoted by estradiol or
> estrogens in general.
>
> Dr Ralph will know more, but I don't think there is
> any doubt that
> androgen as testosterone or dihydrotestosterone (or
> other) is a
> powerful promoter of prostate cancer. That's why
> androgen depletion
> therapy is used therapeutically.
>
> The role of estrogens in prostate cancer is still
> being investigated
> and, as I understand it, they probably play a role
> that is not yet
> fully understood.
Before I try to answer this post it is important that
I issue a disclaimer.
I am and Internist and Gastroenterologist. I am not a
Urologist or Oncologist. I do not treat Prostate
cancer and by no means do I know enough about prostate
cancer to discuss it.
Having said that I went to an Oncology Textbook
(cancer treatment textbook) and read the Chapter on
Prostate Cancer.
<<Abeloff: Clinical Oncology, 3rd ed.
Copyright © 2004 Churchill Livingstone, An Imprint of
Elsevier
Chapter 87 Prostate Cancer>>
Below are what I think are relevant excerpts for this
discussion. All texts enclosed by << ...>> are from
the above textbook.
First of all the chilling facts of the incidence of
prostate cancer in apparently healthy mean.
<<INTRODUCTION
One challenge for prostate cancer screening is the
prevalence of the disease in the United States:
Autopsy series have revealed small prostate cancers in
as many as 29% of men between ages 30 and 40 years and
64% of men between ages 60 and 70 years.[4]>>
These are not men who died from prostate cancer,
rather they are prostate cancer which were found
incidentally. This not new information, since I was
taught this in Medical School 40 years ago.
Nowhere in the chapter is there reference to estrogens
or estradiol with regards to increasing the risk for
prostate cancer. On the contrary in some situations
Estrogen is used to treat prostate cancer.
Along with chemotherapy, radiation therapy, androgen
and testosterone suppression is a very important mode
of treatment especially in the very early states of
prostate cancer.
<<<Metastatic prostate cancer is almost always treated
with androgen deprivation, antiandrogens, or a
combination of androgen deprivation and
antiandrogens.
treatment, androgen-independen
eventually emerge and progress to threaten life.>>>
<<<
THE TREATMENT OF LOCALIZED PROSTATE CANCER
Androgen-deprivatio
prostate cancer brachytherapy both to reduce the size
of the prostate gland and to improve outcomes. Most
prostate glands exhibit some decrease in volume after
3 months of androgen-deprivatio
average 30% to 40% reduction, and little further
volume decreases.[513] About 10% of prostate glands
will show no volume reduction at all in response to
androgen deprivation.
<<<Endocrine Approaches to Prostate Cancer Treatment
The dependence of prostate cancer cells on androgens
for growth and differentiation has been has been well
recognized for at least five decades.[572]
Testosterone, produced by Leydig cells in the testes
on stimulation by LH, is converted to DHT by the
action of 5α-reductase.
DHT, a more potent androgen than testosterone, binds
to intracellular androgen receptors to activate the
expression of target genes.[13][14]
Androgen-deprivatio
involves maneuvers that reduce circulating
testosterone to levels around or below levels present
in castrated men (<50 ng/mL).
Forced reduction of testosterone levels by castration,
or via gonadal suppression, triggers a wave of
apoptosis in both normal and neoplastic prostate
cells, with few or no immediate effects on
non-androgen target tissues, providing one of the most
effective systemic palliative treatments known for
solid organ cancers.
Unfortunately, despite the magnitude of the initial
beneficial treatment response, prostate cancer
inexorably evolves to androgen independence.
therapeutic maneuver has been shown to prevent this
sequence of progression>
It appears that estrogen therapy is just as effective
as orchiectomy (removal of the testicles) however
there are some undesirable side effects.
<<<Strategies for Androgen Deprivation
Currently, a general consensus holds that a reduction
in testosterone produced by the testes represents the
best standard approach to androgen-deprivatio
for prostate cancer.
This can be accomplished by surgical removal of the
testis (bilateral orchiectomy)
synthesis and release of pituitary gonadotropins by
gonadotropin hormone-releasing hormone analogs (GnRH
or LHRH analogs and LHRH antagonists)
administration of pharmacologic doses of estrogens
The administration of pharmacologic doses of synthetic
estrogens represented the earliest strategy for drug
treatment of prostate cancer.[577]
Initial studies using diethylstilbestrol (DES)
revealed a dose-dependent suppression of serum
testosterone to the castrate range.
When used for prostate cancer progression, DES
provided clinical benefits comparable to those
achieved with bilateral orchiectomy.
In a clinical trial conducted by the Veterans
Administration Cooperative Urological Research Group
(VACURG Study 1), men with prostate cancer treated
with DES had a prostate cancer-specific survival
comparable to that of men treated with bilateral
orchiectomy>
It is important to understand that even though you
presently may have a normal PSA, this does not
guarantee that you do not have a dormant or relatively
inactive prostate cancer. As noted above as many as
29% of men between the age of 30-40 were found to have
small prostate cancers at autopsies and as many as 64%
of men age 60-70 were found to have prostate cancer.
Over the years I have been personally interested in
testosterone supplement for myself. I have discussed
this with Endocrinologists and Urologists. The high
probability that at my age (67) there is a relatively
inactive prostate cancer which could be stimulated by
the use of testosterone has dissuaded me from trying
supplements even though I might be able to legally
justify their use.
In my opinion the benefit is not outweighed by the
risk. At present there is no way of knowing, other
than by autopsy or possibly prostate needle biopsy who
has a slow growing prostate cancer. PSA is only
beneficial when the cancer begins to speed up its
growth.
If you have any concerns about the safety of
Testosterone supplementation you should consult a
Urologist or Oncologist who treats this cancer.
At age 60+ using testosterone supplementation is, in
my opinion, like playing Russian Roulette with with a
six shooter loaded with 4 bullets. Not great odds.
Ralph Giarnella MD
Southington Ct USA
> It may help to be clear that in carcinogenesis there
> are usually
> initiation and promotion stages and factors. That
> is, an agent causes
> the initial abnormal cell growth, eg a mutation, and
> other agent(s),
> or perhaps even the same agent, then promote the
> cancer growth and
> the metastases.
>
> It has been suggested that estrogens may initiate
> prostate cancer --
> and so may other lifestyle and environmental
> factors. Yet that does
> not diminish the importance of androgens in
> promotion, ie, making
> that cancer grow. This is what seems to have occured
> in the cases
> reported. Many ageing men have a latent, initiated
> prostate cancer
> that is very slow growing -- unless you stimulate it
> with something.
> One figure I have seen is 30% of men over 50 (NEJM,
> Wolf, 1995).
>
> I would be watching that PSA of yours like a hawk if
> you are taking
> TS.
>
> Paul Rogers
> Gympie, Australia
>
> --- In Supertraining@
> "kendaiganoneill"
> <kayoneill@.
> >
> > How utterly amazing: combining test with estradiol
> finds
> relationship
> > to several incidents of prostate cancer?
> >
> > My physician places far greater emphasis on
> estradiol levels than
> PSAs
> > with respect to men and women - in terms of danger
> of prostate or
> > breast cancer onset. He recommends use of
> probiotics to provide
> > protection against estradiol reuptake. One study
> he mentions
> > demonstrates considerable increase in breast
> cancer incidents among
> > women on antibiotics for three months or longer
> due to compromised
> > probiotics resulting in heightened concentrations
> of estradiol due
> to
> > reuptake.
> >
> > I use testosterone therapeutically. It is
> compounded with an
> aromatase
> > inhibitor to prevent conversion of testosterone to
> estradiol. Why on
> > earth someone would use a combination of test with
> estradiol
> confounds
> > imagination.
> >
> > best regards,
> >
> > Ken O'Neill
> > Austin, Texas
> >
> >
> >
> > --- In Supertraining@
> Giarnella <ragiarn@>
> wrote:
> > >
> > > Bill, thank you for that reference.
> > > Any one who thinks that hormonal supplementation
> for
> > > men in the form of testosterone or its
> precursors is
> > > safe and benign should read the article.
> > >
> > > Ralph Giarnella MD
> > > Southington Ct USA
> > >
> > > --- William Black <wrbmaine@> wrote:
> > >
> > > > Folks:
> > > > Interesting and potentially cautionary item.
> > > > Best,
> > > > Bill Black
> > > > Cumberland Foreside, Maine
> > > >
> > > >
> > >
> >
>
http://www.medpaget
>
tp://www.medpagetod
> > > >
> > >
> >
>
>
>
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