Growth hormone malignancy

The incidence of malignancy is increased in acromegaly, in which growth hormone is present in excess. Patients treated with growth hormone have therefore been carefully monitored. The cancer risk of growth hormone has been reviewed (93). 

A review of Japanese patients found that of the 15 patients who had developed hematological malignancies since 1975, 6 had other risk factors for leukemia, such as Fanconi s syndrome or prior chemotherapy or radiotherapy. The incidence of leukemia in this study was 3 per 100 000, similar to that in the general population of the same age (68). The National Cooperative Growth Study (NCGS—a postmarketing database that includes 19 846 patient-years since the time of growth hormone exposure) similarly reported no increase in the incidence of new leukemia when patients with other risk factors were excluded from the analysis (96). 

In the NCGS study extracranial non-leukemia malignancy rates were similarly not increased in patients treated with growth hormone compared with those who were not (102). 

Despite theoretical concerns, there is no evidence that either intracranial or extracranial malignancy, new or recurrent, is increased in subjects treated with growth hormone (97,98,99). Despite this, certain precautions are... 

In the treatment of disseminated malignant melanoma including cerebral localization and primary malignant — Cerebral tumors Ophthalmic Contrast media Contrast media Antiviral Anticancer Lipid-lowering agent Growth hormone Herbal extract Antidiabetic Antidiabetic Antidiabetic (herbal)... 

The incidence of malignancy is increased in acromegaly, in which growth hormone is present in excess. Patients treated with growth hormone have therefore been carefully monitored. The first report of leukemia in Japanese children treated with growth hormone (73) prompted a worldwide survey. There have been reports of 44 new cases of leukemia in growth hormone recipients, of which only 20 were acute lymphoblastic leukemia. This is much less than the expected 80-85% of new childhood leukemia (74). 

Despite theoretical concerns, there is no evidence that either intracranial or extracranial malignancy, new or recurrent, is increased in subjects treated with growth hormone (76,78,79). Despite this, certain precautions are still recommended for children who have previously been treated for cancer. The diagnosis of growth hormone deficiency should be clearly established (74) and it is recommended that treatment be delayed for at least 1 year after tumor therapy has been completed (36). 

Fig. 4. Four routes of cellular secretion of gastrin. Several other regulatory systems, wherein the same peptide acts as hormone, neurotransmitter, and growth factor, are also released as they occur in these four cell types. Autocrine and paracrine secretion are assumed to play decisive roles for the growth of malignantly transformed cells.

Neuroprotection in Parkinson s disease Growth-hormone deficiency Brain malignancies Ulcerative colitis Growth-hormone deficiency... 

Octreotide is a growth hormone suppressant and is useful in the treatment of acromegaly, not malignant tumors of the brain. 

IGF levels. IGF-I mediates the effects of growth hormone, which is mainly secreted by liver but is also produced in several other tissues. IGF-I can act in an autocrine and paracrine maimer to promote normal growth and malignant cellular proliferation. In vitro, low micromolar concentrations of lycopene have slowed cancer cell proliferation by suppressing response to IGF-I. " There has been considerable progress recently in the understanding of the hormonal causes of prostate cancer. Particularly, a number of studies have shown a positive association between IGF-I and the incidence of prostate cancer, whereas the association was reversed after radical prostatectomy and/or treatment with lycopene. ... 

FIGURE 96-4. Pathophysiology of the hypercalcemia of malignancy. PTHrP, parathyroid hormone-related protein TGF-P, transforming growth factor P TNF-a, tumor necrosis factor alpha Ca2+, calcium IL-1, interleukin 1 IL-2, interleukin 2. 

Although steroids have been studied for many years, steroid hormones continue to be a rich area of medicinal chemistry study. Steroids continue to be evaluated for their therapeutic role in the treatment of cancer, especially malignancies whose growth characteristics are hormonally responsive. In recent years, the increased recognition of the role of steroids in the brain has resulted in ongoing projects to evaluate steroids as general anasthetics and anticonvulsants. Also, the search for compounds that bind to steroid receptors, but which are not steroidal in their molecular structure, is another important area of research. 

---