Androgens cancer, risk

Diamond TH, Bucci J, Kersley JH, Aslan P, Lynch WB, Bryant C. Osteoporosis and spinal fractures in men with prostate cancer risk factors and effects of androgen deprivation therapy. J Urol 2004 172 529-32. 

Tibolone has combined estrogenic, progestogenic, and androgenic activity. Its effects depend on metabolism and activation in peripheral tissues. Tibolone has beneficial effects on mood and hbido and improves menopausal symptoms and vaginal atrophy. It protects against bone loss and reduces the risk of vertebral fractures. It reduces total cholesterol, triglyceride, lipoprotein (a), and, unfortunately, high-density lipoprotein concentrations. It may increase cardiovascular risk, breast cancer risk, and endometrial cancer risk. 

Dorgan, J. F., Longcope, C., Stephenson, H. E., Jr., etal.. Relation of prediagnostic serum estrogen and androgen levels to breast cancer risk. Cancer Epidemiol. Biomarkers Prev. 5, 533-539 (1996). 

Contrast the benefits and risks of luteinizing hormone-releasing hormone (LHRH) singleagent therapy and combined androgen blockade in the first-line therapy of metastatic prostate cancer. 

CAG repeat length. Shorter CAG repeat sequences have been found in African Americans. Therefore, the combination of increased testosterone and increased androgen receptor activation may account for the increased risk of prostate cancer for African-American men.2 The Asian diet generally is considered to be low in fat and high in fiber with a high concentration of phytoestrogens, potentially explaining the decreased risk in Asians.4... 

Patients with T3b and T4 disease have a very high risk of recurrence and are not candidates for radical prostatectomy because of extensive local spread of disease.26 Androgen ablation with an LHRH agonist plus an antiandrogen should be used prior to radiation therapy for patients with locally advanced prostate cancer to improve outcomes over radiation therapy alone. 

Kahl, P., Gullotti, L., Heukamp, L.C., Wolf, S., Friedrichs, N., Vorreuther, R., Solleder, G., Bastian, P.J., Ellinger, J., Metzger, E., Schule, R. and Buettner, R. (2006) Androgen receptor coactivators lysine-specific histone demethylase 1 and four and a half LIM domain protein 2 predict risk of prostate cancer recurrence. Cancer Research, 66, 11341-11347. 

Androgen deprivation therapy (ADT) is being used increasingly as neo-adjuvant and adjuvant therapy. Neo-adjuvant ADT for 4-6 months before external beam radiation can enhance survival and reduce the prostate volume to be irradiated. Similar benefits have not been seen prior to radical prostatectomy. The benefits of neo-adjuvant therapy are most evident for high risk localized prostate cancer. Adjuvant ADT for up to 2 years following external beam radiation increases disease-free survival and overall survival for locally advanced (T3) tumors. 

Oral androgens as may be used in hormone therapy for the management of metastatic breast cancer are effective in about 30% of women regardless of age, but virilizing doses of the hormone are usually required. The oral androgens carry the additional risk of toxic hepatitis. 

The use of testosterone replacement therapy for the treatment of hypogonadism and ED may assist PDE5 inhibitors if they have failed to be effective (57). Testosterone levels within the normal range have neutral or potentially beneficial effects on the cardiovascular system (58). Androgen replacement therapy should be offered to men with CAD and hypogonadism if symptomatically appropriate. The absence of long-term studies needs to be addressed in terms of possible preventive properties on the vascular wall, reduction in low-density lipoprotein levels, and the reduction of insulin resistance in contrast to the increase in hematocrit and risk of exacerbating prostate cancer. 

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