# New Concepts Regarding Testosterone and Prostate Cancer...



## event462 (Jul 10, 2014)

Here's is an interesting read! When I asked my doc about trt she quickly mentioned the increased risk of prostate cancer. I wish I had this article to show her at the time! 



New Concepts Regarding Testosterone and Prostate Cancer: A Breath of Fresh Air
Morgentaler A. New concepts regarding testosterone and prostate cancer: a breath of fresh air. Oncology (Williston Park) 2014;28(5):404-5.   http://www.cancernetwork.com/oncolo...osterone-and-prostate-cancer-breath-fresh-air

After a quarter of a century struggling to decipher what is true and untrue about prostate cancer (PCa) and androgens, the review by Paul Mathew in this issue of ONCOLOGY comes as a breath of fresh air. What a pleasure to read a new perspective on a problem that has been bedeviled by rigid ideas developed more than 70 years ago, like flies fixed in amber!

Evidence soon accumulated that none of the basic tenets of the androgen hypothesis were correct. High levels of serum testosterone or dihydrotestosterone are not associated with increased risk of PCa. Androgen deprivation does reduce PSA levels, but raising serum testosterone well into the supraphysiologic range for months in otherwise healthy men has been shown to have no effect on mean PSA level or prostate volume.

The explanation for this, termed the saturation model, is that the ability of testosterone to stimulate PCa growth is finite, with maximal stimulation occurring at fairly low serum testosterone concentrations, in the range of 250 ng/dL. Thus, the “high testosterone is risky for prostate cancer development” part of the androgen hypothesis also has proved incorrect.

What about the concept that administering androgens to a man with prostate cancer will universally cause rapid growth?

In 2011, my colleagues at Baylor College of Medicine and I reported on 13 men with untreated PCa, on active surveillance, who received testosterone therapy for a mean of 2.5 years. There was no increase in mean PSA level, or in prostate volume. No man demonstrated cancer progression—and all men reported subjective improvement in symptoms.

Our more recent single-center experience at Men’s Health Boston with a larger group of 33 men was presented at the annual meeting of the American Urological Association in 2013, with similar reassuring results. These results support the validity of the saturation model.

If none of the tenets of androgen hypothesis orthodoxy are correct, then what are we left with?

Dr. Mathew takes us several steps down this new path. Whereas the primary thrust of the last 7 decades of research into treatment of advanced prostate cancer has been to find ways to more completely deprive PCa of androgen, Dr. Mathew asks a completely different question: Are there ways in which testosterone administration may be beneficial?

Basic science and a number of clinical experiences have suggested for years that steroid hormones may have bifunctional roles, as Dr. Mathew puts it. As the androgen hypothesis finally fades from prominence, now is an excellent time to shake the sleep from our eyes, breathe in the fresh air, and look again at a world of new possibilities.


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## juuced (Jul 14, 2014)

its sad so many doctors dont keep up with the latest science.  They should be ashamed of themselves.


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## IronSoul (Jul 15, 2014)

Awesome post brother, good read!


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