Endocrine Measures

Several studies evaluated endocrine measurements, specifically testosterone and follicle stimulating hormone (FSH), as primary or secondary endpoints. Testosterone is of clinical importance both as a risk factor for cancer and as part of the initial evaluation of male infertility. FSH is also measured as an initial evaluation of infertility in both men and women. Despite the substantial number of studies, results were conflicting and no significant effect of soy product consumption was found in men, pre- or postmenopausal women (Balk et al., 2005). 

Measurement of contaminants in fish has concentrated on muscle tissue since the aim has generally been to protect the health of the consumer rather than that of the fish. Endocrine tissue such as the gonads has been much more rarely examined, while data for adrenal, thyroid and pituitary levels are virtually non-existent. More data are available for the liver, as a lipid rich tissue and the major site of xenobiotic catabolism, but the concentrations have rarely been related to its capacity to produce vitellogenin or metabolise endogenous hormones. Tissue concentrations of a wide range of chemicals, are at a level which suggests that, either alone or in combination, they will cause significant endocrine disruption in fish in many polluted habitats. 

It is also clear that it is difficult to relate cause and effect to any specific chemical since, with the exception of point source effluents, many waterways contain a multitude of chemicals, of which the active endocrine disruptor may not be that which has been measured in the water or tissue. For such reasons, many studies have used in vitro experiments in which isolated tissue, either from a control animal or one captured in a polluted water system, is exposed to a single pollutant in the laboratory. Such experiments have shown significant disruption to testicular activity by a wide range of xenobiotics, including cadmium, lindane, DDT, cythion, hexadrin and PCBs. ... 

Some biomarkers only provide a measure of exposure others also provide a measure of toxic effect. Biomarkers of the latter kind are of particular interest and importance and will be referred to as mechanistic biomarkers in the present text. Some mechanistic biomarker assays directly measure effects at the site of action as described in Section 2.4 (see Chapter 4, Table 4.2, for examples). Inhibition of acetylcholinesterase is one example. Others measure secondary effects on the operation of nerves or the endocrine system (examples given in Table 4.2 and Chapters 15 and 16). 

Determine success of the overall treatment plan by obtaining a thorough history of adverse events experienced with the previous chemotherapy/endocrine therapy treatment and objective measures of response to therapy. Assess effects on quality-of-life measures such as physical, psychological, and social function and well-being. 

Patients must be monitored to assess their response to treatment and to detect recurrent diseases. PSA as a specific marker for prostate cancer is most useful in monitoring patients who have been treated with radical prostatectomy, radiation therapy, or endocrine therapy. The concentration of PSA falls to undetectable levels following a radical prostatectomy because all prostate tissue has been removed. Generally, PSA is measured at periodic intervals. In studies, the extent of disease at the time of surgery correlated well with the postoperative PSA concentration. A significant measurable PSA concentration after prostatectomy indicates that residual tumor may be present. PSA concentrations decline gradually after radiation therapy (36). 

NS (chronic) (general population) Endocrine No effect on thyroid function in children 2-77 (levels measured) Siegel et al. 1989 Huseman et al. 1992... 

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