Testosterone Therapy: No Prostate Cancer Link

[liftsiron]

05/11/2004 Testosterone Therapy: No Prostate Cancer Link
Contrary to Belief, Testosterone Doesn't Raise Risk of Prostate Cancer, Study Shows
By Jeanie Lerche Davis WebMD Medical News
Reviewed By Michael Smith, MD on Thursday, January 15, 2004

Larry's Comments

Jan. 15, 2004 -- One of doctors' greatest fears about testosterone therapy is that it may cause prostate cancer. But a new study shows that it won't increase a man's risk of prostate cancer -- even if he has precancerous prostate cells.

The study sheds light on the risks of testosterone therapy, which is used in men with low testosterone levels to help restore a man's sexual function, mood, memory, even aspects of his physique -- muscle mass, strength, body fat, bone density.

However, doctors have been concerned that testosterone therapy could trigger growth of prostate cancer -- especially if a man already has precancerous cells in his prostate, writes researcher Ernani Rhoden, urologist with Beth Israel Deaconess Medical Center and Harvard Medical School.

Rhoden's paper appears in the December 2003 Journal of Urology.

His study involved 20 men who had precancerous cells in the prostate and 55 men who had no signs of these cells.

After one year of testosterone therapy, Rhoden's researchers looked at prostate-specific antigen (PSA) levels for all the men. Rising PSA levels are an indication that a man may have prostate cancer.

The PSAs were very similar for both groups -- both before and after testosterone therapy, he reports.

These results indicate that testosterone therapy does not lead to prostate cancer and that men with a history of precancerous prostate cells may be able to safely take testosterone therapy, Rhoden writes.

SOURCE: Rhoden, E. Journal of Urology, January 2004; vol 170: pp 2348-2351.

© 2003 WebMD Inc. All rights reserved.


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Larry's Comments - originally appeared in the March 03, 2004 issue of The Compounder Newsletter.

Does Testosterone CAUSE Prostate Cancer?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
I don't know how it all started - but there is a long-standing BELIEF that testosterone is somehow responsible for prostate cancer. Men who have been diagnosed with this kind of cancer are warned to avoid testosterone altogether. Sometimes drugs are used to reduce the levels of testosterone. And, the ultimate insane insult - some men have been castrated to lower the danger from their prostate cancer.

Over the years I have commented on this whole stupid idea. There's one basic fact that all the scientific geniuses seem to ignore. Men get prostate cancer when they're older - a time when their testosterone levels are declining. They DON'T get prostate cancer when they're young (in their teens, twenties or thirties). Oh, sure, there are documented cases of prostate cancer in young men - but they are so rare that to consider it normal is truly bizarre. When testosterone levels are their highest the prostate cancer rate is at the absolute lowest - practically zero.

It may be that testosterone is somehow protective of prostate tissue - or that in normal amounts it balances some of the negative effects of estrogen (after all, estrogen is a major cause of cancer). While it may not be a CURE for prostate cancer, testosterone really should not be viewed as as the villain.

In our 21st century world cancer is rampant and I attribute it to the overall imbalance of estrogen (and estrogen-like substances). I'd guess that a majority of people are estrogen dominant these days - they ought to have their estrogen levels balanced with physiologic doses of progesterone. That's the first step to hormone health. Next, I think people ought to learn their levels of hormones - by a saliva test of course! Then if there are any deficiencies (and associated symptoms) steps should be taken to obtain hormone supplements.

Living longer and being healthy are possible. If prostate cancer strikes it can be treated - often without radiation or surgery. Dr. John R. Lee once told me that a great treatment for prostate cancer is a combination of progesterone and testosterone - in a transdermal cream. "Everyone" in the medical community said he was nuts (or something that means that but sounds more polite), because "everybody knows" that testosterone can make prostate cancer worse). Well, well, well (no, not three holes in the ground!). It seems that somebody has actually decided to find out if testosterone can cause prostate cancer. The answer? Nope, it sure doesn't look like its dangerous at all. The above study was recently reported on by WebMD.

 

[StoneColdNTO]

Nice article............

 

[DADAWG]

thanks liftsiron

 

[Victorian guy]

PHEW.....I read a news article on how prostrate cancer survivors life sucks, ie incontinence, reduced sexual function....and had worries about my test use...still, this is just one study...

His sample group doesnt seem that big- 75 people total? and only 20 from one population?

 

[Mudge]

It seems somewhat clear that estrogen and DHT are the biggest problems, as well as infrequent ejaculation.

 

[liftsiron]

Let's Revisit the Prostate Cancer Debate
Courtesy of John R. Lee, M.D. Medical Letter

Conventional treatments clearly aren't working - what's a guy to do?

Prostate problems are the fastest-growing health concern among men in Westernized countries, and the rate of prostate cancer is increasing steadily. I receive plenty of mail on the subject, and I'm afraid my response isn't always welcome news. I have to tell them that prostate cancer becomes progressively more common with age, and that conventional treatments (surgical or chemical castration, radiation, or surgical removal of the prostate) don't do much good and in fact are likely to cause rather undesirable side effects.

The Journal of the American Medical Association (JAMA) of June 28, 2000, carried an article comparing treatment recommendations by radiation oncologists and urologists for men with moderately well differentiated, localized prostate cancer and greater than a 10-year life expectancy based on age. In such cases, 92 percent of urologists recommend radical prostatectomy (removal of the prostate gland), whereas 72 percent of radiation oncologists recommend radiation treatments. An accompanying editorial points out that the treatment advice is determined by the services the doctor provides rather than by any clear-cut evidence of the superiority of either treatment, or even whether or not either treatment is any better than watchful waiting. And I find it interesting that none of them recommended any nutritional or hormonal alternative management.

Worse than Doing Nothing

The value of PSA (prostate specific antigen) testing to detect prostate cancer, though touted as a proven strategy for early detection, is also questionable. IN Sweden, for example, physicians rarely screen for prostate cancer or use radical therapies, choosing watchful waiting instead. Despite this, mortality rates for prostate cancer have declined in Sweden. In the U.K., prostate cancer mortality rates are similar to the U.S. even though PSA screening is not routinely performed. In older men, when prostate cancer occurs, the cancer is slow-growing and early intervention may be of little consequence.

A Better Way to Treat Prostate Cancer

If radical treatments such as castration, radiation or prostatectomy are no better than watchful waiting, I believe it is time to reanalyze our underlying hypotheses concerning prostate cancer. The present treatments are based on a war metaphor - find the abnormal cells and obliterate them by radiation or surgical removal. Little thought is given to the underlying metabolic causes that change normal cells into cancer cells. As with any disease, once the cause is identified, successful prevention and treatment strategies emerge.

Conventional medicine has fixated, despite lack of credible evidence, on testosterone as a presumed cause of prostate cancer. When looking at the many studies that compared hormone levels with the occurrence of prostate cancer, there is no correlation with elevated testosterone levels. If high testosterone levels caused prostate cancer, why don't 18 year-old men get it? The fact that some evidence shows a modest survival benefit from orchiectomy (castration) does not mean that testosterone reduction was the operative factor. The testes make other hormones as well, and the observed prostate benefit of castration may stem from reducing one or another of them.

The role of estrogen dominance provides a more probable hypothesis. Estrogen dominance is the only known cause of endometrial (uterine) cancer. The prostate is the male equivalent of the uterus; they both developed from the same embryonic cells. They both contain the oncogene, Bcl-2, and the cancer-protective gene, p53. And it has been shown that estradiol "turns on" p53 which blocks Bcl-2 in both breast cells and prostate cells. This suggests that if the ration of testosterone to estradiol in men changes so that the estradiol effect becomes dominant, prostate cancer cells develop. Recent studies no find that this correlation is fact.

What's Happening with Men's Hormones?

Estrogen levels are rising in the general population in Westernized countries due to pervasive pollution of the environment by chemicals that are estrogen mimics (aka xenoestrogens), such as pesticides, plastic residues and dozens of industrial chemicals such as dioxins and PCBs. This is partially why most postmenopausal women need progesterone (to oppose or balance the estrogen), and it's no doubt one reason that the incidence of prostate problems is increasing so rapidly in men.

Estrogen levels increase in aging men who are overweight because fat cells convert the male hormone androstenedione into estrogens, which then stimulates prostate growth. Thus, the more fat a man carries on his body, the higher his estradiol levels are likely to be. Regular exposure to pesticides through spraying in the home or garden only adds to the problem. Even if a middle-aged man's testosterone levels are normal, if his estradiol levels are high he can have estrogen dominance symptoms such as weight gain, larger-than-normal breasts, gall bladder problems, anxiety and insomnia, and prostate enlargement that leads to urinary problems.

The crux of the present confusion about men's hormones is the matter of achieving hormone balance. Hormone balance refers not to absolute concentrations of any given hormone, but to the ration of one hormone with another. It is the ratio of salivary concentrations of testosterone to estradiol that best reflects the hormone-related risk of prostate cancer.

To sum up, as men age, their testosterone concentrations decline but their estradiol concentrations do not; those commonly rise a bit, and the ration of testosterone to estradiol falls. Testosterone is a potent antagonist of estradiol and its effects on the body. When testosterone levels decrease, estradiol becomes dominant. Estradiol not only stimulates prostate cell proliferation but also activates the oncogene Bcl-2. One by one, normal prostate cells become cancerous prostate cells.

This fits with findings of ultra-scans and prostate biopsies - the cancer cells are found in various small clusters here and there throughout the prostate, and not as a single prostate cancer mass.

Treatment of Hormone Imbalance in Men

Hormonal treatment should correct the estrogen dominance by supplemental testosterone. If saliva tests find progesterone deficiency, progesterone supplementation is also indicated since it inhibits 5 alpha-reductase, the enzyme that converts testosterone to dihydrotestosterone (DHT). High levels of DHT are correlated with prostate cancer.

Conventional treatments such as surgical or chemical (e.g., Lupron) castration stop the testes from making all sex hormones. The observed cancer benefit is not due to testosterone reduction, but is more likely due to the decrease in estradiol production. However, this approach sacrifices the potential benefits of testosterone and progesterone (men make small amounts of progesterone in their testes and adrenal glands). Restoring physiologic levels of testosterone and progesterone to prevent estrogen dominance is a happier solution to the problem.

The clinicians I've spoken to who are working successfully with men who have prostate problems prescribe 4 to 6 mg of testosterone daily, preferably delivered by a patch or cream. The high dose of testosterone often prescribed by conventional physicians (as much as 300 mg daily!) is an invitation to hormone imbalance in the other direction and a wide range of physical and emotional side effects. It is absolutely not necessary to take high doses of testosterone to achieve hormone balance.

My friend David Wastchak, R.Ph., Ph.D. is a pharmacist and biochemist who specializes in compounding hormone creams, and he has quite a bit of experience in putting together progesterone and testosterone creams for me. You can have your doctor call him for a consultation and prescription at (602) 271-9577.

Up to this point the discussion has concerned the treatment of prostate cancer, but prevention is your best bet. In addition to maintaining a healthy hormone balance as mentioned above, prevention of prostate cancer undoubtedly involves other factors such as diet, specific nutrients, essential fatty acids, stress managements, and antioxidants. Whole foods such as broccoli and cabbage are attracting great interest as cancer fighters. The nutritional advice on cancer that I give to women in the chapter in my "PREmenopause" book also applies to men.

In conclusion, the conventional testosterone hypothesis is a 60 year-old mistake. Present treatments are fraught with undesirable side effects and their purported benefits are little different than that of watchful waiting. Extensive usage of PSA tests has done little to change prostate cancer mortality rates. Fortunately, new studies teach us that estrogen dominance (a falling testosterone to estradiol ratio) may have a great deal to do with getting prostate cancer. This is where we need to start.

 

[Golden_Muscle]

Does it enlarge the prostate? I think it does.

 

[Mudge]

BPH (benign prostate hypertrophy) can occur with testosterone use, Nandi says he has a problem with that and can't go anywhere near 1g a week.

Supposedly HCG actually helps with this, there is an article somewhere at CEM about it.

 

[liftsiron]

I get BPH very bad with antihistimine use and somewhat with eca, I never have had problems with BPH from test, regardless of the dose. I do know others who have though.

 

[tee]

Great info Lifts! Thanks.