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Nathan Goodyear

Testosterone replacement therapy and the risk of prostate cancer - 0 views

www.ncbi.nlm.nih.gov/...PMC4814970

Testosterone testosterone therapy saturation theory cancer prostate cancer male hormones

shared by Nathan Goodyear on 01 Oct 16 - No Cached
  • When the level of circulating androgen is below normal, some androgen receptors are inactive, and the secondary downstream effects are decreased. Once androgen receptors within the prostate are saturated, however, increasing testosterone will no longer have an effect
  • the saturation point is thought to occur at low physiologic testosterone levels
  • Only the subset of individuals with pretreatment testosterone level <250 ng dl−1 had PSA level correlating with free and total testosterone level
  • ...7 more annotations...
  • none of the men stopped testosterone supplementation due to prostate cancer recurrence, and none demonstrated cancer progression
  • PSA level did transiently rise in one patient; however, none exceeded a PSA of 1.5 ng ml−1 to raise concern for biochemical recurrence
  • after 19 months on TRT, 10 hypogonadal patients with a history of undergoing a radical retropubic prostatectomy for prostate cancer had no PSA recurrence and had statistically significant improvements in serum total testosterone and hypogonadal symptoms
  • Similarly, Kaufman and Graydon14 examined case records of seven hypogonadal men who had undergone curative RP with symptoms of hypogonadism and low serum testosterone levels treated with testosterone replacement. No biochemical or clinical evidence of cancer recurrence was noted
  • In a much larger case series, Khera et al.15 reviewed the records of 57 men who received TRT following RP. After an average of 36 months following RP, testosterone replacement was initiated and followed for an average of 13 months. Mean testosterone values rose significantly and once again, there was no increase in PSA values and, therefore, no diagnosed biochemical recurrence
  • Four of the patients in the treatment group were found to have cancer recurrence, compared with eight in the control group
  • All biochemical recurrences were seen in individuals with high-risk disease
  • Nathan Goodyear on 01 Oct 16
     
    Good review of data on Testosterone therapy and prostate cancer risk: the take home is there is no increased risk.  Also, included is a discussion of the prostate saturation theory.
Nathan Goodyear

Testosterone Replacement Therapy in Patients with Prostate Cancer After Radical Prostat... - 0 views

www.ncbi.nlm.nih.gov/...PMC4544840

Testosterone low T low Testosterone Testosterone therapy prostate cancer PSA biochemical recurrence male hormones hormones cancer prostate

shared by Nathan Goodyear on 10 Oct 16 - No Cached
  • Nathan Goodyear on 10 Oct 16
     
    One of the largest studies to date on Testosterone therapy in men post radical prostatectomy for prostate cancer.  This study supports the use of Testosterone therapy in this men with close f/u. A higher biochemical recurrence rate was found in the control group versus the treatment group, though there were 4 with biochemical recurrences in the treatment group.
Nathan Goodyear

http://www.tandfonline.com/doi/pdf/10.4161/cc.8.23.10238 - 0 views

www.tandfonline.com/...cc.8.23.10238

reverse warburg effect war warburg effect cancer mono-carboxylate transporters CAFs fibroblasts

shared by Nathan Goodyear on 11 Nov 14 - No Cached
  • Nathan Goodyear on 11 Nov 14
     
    Good biochemical review of the Reverse Warburg Effect.  In pdf format, so I can't highlight.
Nathan Goodyear

The implication of neuroactive steroids in Tourette syndrome pathogenesis: a ... - 0 views

www.ncbi.nlm.nih.gov/...PMC3849218

tourette's syndrome hormones 5-alpha reductase

shared by Nathan Goodyear on 08 Dec 15 - No Cached
  • The typical onset of TS occurs at 6–7 years of age and is characterized by the appearance of simple, recurrent motor tics, followed by the manifestation of phonic tics after several months [12]. In most children, TS symptoms undergo a progressive exacerbation, which reaches its zenith at the beginning of puberty (11–12 years of age), and is then followed by a gradual remission in the majority of patients
  • 30–40% of TS-affected children retain their symptoms in adulthood
  • Multiple neurotransmitters have been implicated in TS, including dopamine (DA), serotonin, norepinephrine, acetylcholine, glutamate and γ-amino-butyric acid (GABA)
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  • female gender may predict greater tic severity in adulthood
  • male gender is a major risk factor for TS (with a male:female prevalence ratio estimated at ~4:1)
  • the typical age of onset coincides with adrenarche (6–7 years old); symptoms increase in severity until the beginning of puberty (12 years old) and then undergo a spontaneous amelioration, which becomes apparent with the end of puberty (at 18–19 years of age)
  • TS is diagnosed later in females than males
  • ample evidence supports the involvement of DAergic dysfunctions in TS
  • a number of clinical observations showed that tics in TS patients could be exacerbated by anabolic androgens
  • steroidogenic enzymes and androgen receptors may serve as putative therapeutic targets for this disorder
  • Unlike males, tic severity is typically increased after puberty in females
  • 26% of females were found to experience exacerbation of tics in the estrogenic phase of the menstrual cycle, and this phenomenon was found to be correlated with increased tic severity at menarche
  • biochemical hallmark of adrenarche is the acquisition of 17,20 lyase activity by cytochrome P450 C17 (CYP17A1)
  • increased synthesis of dehydroepiandrosterone (DHEA) and androstenedione, which leads to the growth of axillary and pubic hair as well as enhancement in the oiliness of the skin
  • Nathan Goodyear on 08 Dec 15
     
    interesting read on hormones and tourette's.. Proposed that 5 alpha reductase activity is involved in worsening of tics.  This makes sense as Testosterone in men with low T is known to increase dopamine and dopaminergic dysfunction is known to play a role in tourette's;  the clinical presentation of girls vs boys is very different.  The authors of this article propose that 5 alpha reductase activity controls a back door method where by progesterone is converted to androgens.
Nathan Goodyear

Gleason Score and Lethal Prostate Cancer: Does 3 + 4 = 4 + 3? - 0 views

www.ncbi.nlm.nih.gov/...PMC2717753

prostate cancer cancer prostate Gleason score

shared by Nathan Goodyear on 16 May 18 - No Cached
  • The Gleason system, introduced in 1974
  • is an architectural grading system that ranges from 1 (well differentiated) to 5 (poorly differentiated)
  • The Gleason score (GS) is the sum of the primary and secondary patterns with a range of 2 to 10
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  • patients with GS ≥ 7 are at greater risk for extraprostatic extension and biochemical recurrence
  • It is widely accepted that Gleason grade from biopsy is frequently upgraded at prostatectomy, resulting in a reluctance to assign a low GS at diagnosis
  • Nathan Goodyear on 16 May 18
     
    Review of Gleason score in prostate cancer.
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