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Nathan Goodyear

Inflammation and prostate cancer, Future Oncology, Future Medicine - 0 views

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    low T:E2 ratio increases inflammation in prostate.  This has implications in prostatitis and prostate cancer.
Nathan Goodyear

Aromatase and regulating the estrogen:androgen ratio in the prostate gland - 0 views

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    This article summarizes it all.  With age, Testosterone declines and estrogen production, through elevated aromatase activity, increases.  This results in a decline in the Testosterone:estradiol ratio.  This has been clearly implicated in both benign and disease states of the prostate.  The evidence points to aromatase activity and estrogen in the prostate to poor prostate health.  Additionally, this article points out the impact of ER alpha and ER beta on the translation of the message of Estrogen.
Nathan Goodyear

Estrogen and prostate cancer: An eclipsed truth in an androgen-dominated scenario - Carruba - 2007 - Journal of Cellular Biochemistry - Wiley Online Library - 0 views

  • Aberrant aromatase expression and activity has been reported in prostate tumor tissues and cells, implying that androgen aromatization to estrogens may play a role in prostate carcinogenesis or tumor progression
  • imbalance of their expression may be critical to determine the ultimate estrogen effects on prostate cancer cells
  • In prostate cancer, ERβ activation appears to limit cell proliferation directly or through ERα inhibition, and loss of ERβ has been consistently associated with tumor progression
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    High aromatase activity and ER alpha expression/signaling associated with prostate disease.
Nathan Goodyear

Analysis of Relations between serum levels of Epitestosterone, Estradiol, Testosterone, IGF-1 and Prostatic Specific Antigen in men with Benign Prostatic Hyperplasia and Carcinoma of the Prostate - 0 views

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    Great confusion exists in the medical profession about Testosterone and PSA and the health of the prostate. The conversion of Estrogen, whether E2 or E1, and other variables are responsible for increases in PSA while on Testosterone therapy. This study points out that Estradiol in men stimulates cell line growth of prostate cancer. In contrast, Epitestosterone, an androgen metabolite, has antiandrogen, inhibits this estrogen activity. Epitestosterone exists in an inverse relationship to Estradiol and IGF-1.
Nathan Goodyear

Intermediate and Longer-Term Outcomes From a Prospective Active-Surveillance Program for Favorable-Risk Prostate Cancer - 0 views

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    low aggressive prostate cancer followed conservatively results in low mortality rate in study.  The study is significant in that it followed 1,298 men up to 18 years and found reclassification to "lethal" grade prostate cancer to be only 5.9%.  This challenges long held dogma that the first approach to cancer is to cut it out. For those with low aggressive prostate cancer, conservative approaches i.e. observation, can be employed.
Nathan Goodyear

Increased Endogenous Estrogen Synthesis Leads to the Sequential Induction of Prostatic Inflammation (Prostatitis) and Prostatic Pre-Malignancy - 0 views

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    male mouse model finds estrogen can induce prostatitis and dysplasia of the prostate.
Nathan Goodyear

The safety of testosterone supplementation ther... [Nat Rev Urol. 2014] - PubMed - NCBI - 0 views

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    Review, only abstract available--Testosterone therapy does not affect prostate size, intraprostatic Testosterone levels, or prostate cancer progression.  Carcinogenesis of the prostate is not a androgen driven process.  It is an aromatase process.  DHT metabolites can promote tumor growth via Estrogen receptors later, but initiation, via all accounts, occurs through aromatase expression and production of estrogen in the prostate.
Nathan Goodyear

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

  • 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
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  • 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
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    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

http://onlinelibrary.wiley.com/store/10.1002/tre.178/asset/178_ftp.pdf;jsessionid=F122C7B33C8E447F14B0F0AE2690DD32.f03t02?v=1&t=it8y4ddd&s=5b3e62873a24ff3d2f9f216df22e199a5068cbc4 - 0 views

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    A revisit of the saturation model of Testosterone therapy and prostate cancer.  Review finds Testosterone therapy does not "appear to promote prostate cancer growth".  The saturation model is the thought around the AR.  At low concentrations, there is a greater sensitivity of Testosterone to AR binding at very low T levels; but above those very low T levels, prostate cancer becomes insensitive to the Testosterone.
Nathan Goodyear

[Prostatic inflammation and prostate cancer]. [Urologe A. 2010] - PubMed - NCBI - 0 views

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    chronic prostatitis linked to increase prostate cancer risk
Nathan Goodyear

Oestrogen and benign prostatic hyperplasia: effects on stromal cell proliferation and local formation from androgen - 0 views

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    this study finds aromatase presence in the stroma of the prostate and not the epithelium of the prostate.  This would support the thought that increased aromatase activity and thus conversion of Testosterone to Estradiol in the prostate stroma contributes to BPH.
Nathan Goodyear

Essential Role for Estrogen Receptor β in Stromal-Epithelial Regulation of Prostatic Hyperplasia - 0 views

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    ER beta agonists shown to be anti-proliferative in the prostate and "ablated preexisting prostatic epithelial hyperplasia".  This has important implications: low T conditions increase ER alpha expression, which increases ER alpha production.  Low T is a pro inflammatory state in men, which increases aromatase activity.  Thus increase conversion of T to E2 in the stroma of the prostate results in growth.  ER beta is not activated.
Nathan Goodyear

Estrogen Receptor β in Prostate Cancer: Brake Pedal or Accelerator? - 0 views

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    Great article on ER beta and the prostate.  ER alpha expression is very important in the development of the prostate.  IN that instance, ER beta is down regulated.  In prostate cancer generation, ER beta expression in the epithelium is lost.
Nathan Goodyear

Oestrogen and benign prostatic hyperplasia: effects on stromal cell proliferation and local formation from androgen - 0 views

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    Much has been debated about the effects of androgens on prostate growth.  However, growing evidence is emerging that prostatic aromatase activity is responsible.  This study finds that high aromatase activity and thus Testosterone to Estradiol conversion in the prostate stroma is responsible for the pathogenesis of BPH.
Nathan Goodyear

Low testosterone level predicts prostate cancer in r... [BJU Int. 2012] - PubMed - NCBI - 0 views

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    study finds high incidence of prostate cancer in those with low Testosterone at the time of biopsy for HGPIN. What is also interesting, is that the authors found a higher SHBG.  It is well known that Estradiol increases SHBG.  It is also well known that Testosterone to Estradiol in the prostate plays a role in prostate cancer.
Nathan Goodyear

Review of health risks of low testosterone and testosterone administration - 0 views

  • Hypogonadism may be defined either as serum concentration of T (either total T, bioavailable T or free T) or as low T plus symptoms of hypogonadism
  • The Baltimore Longitudinal Study on Aging reported the incidence of total serum T < 325 ng/dL to be 20% for men in their 60s, 30% for men in their 70s and 50% for men over 80
  • The Massachusetts Aging Male Study reported that 12.3% of men aged 40 to 70 had a total serum T of < 200 ng/dL with 3 or more symptoms of hypogonadism
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  • The Boston Area Community Health Study reported that 5.6% of men aged 30 to 70 were hypogonadal, as defined by total serum T < 300 ng/dL; or, free serum T < 5 ng/dL plus 3 or more symptoms of hypogonadism
  • In a health screening project among 819 men in Taiwan, the prevalence of hypogonadism (total serum T < 300 ng/dL) ranged from 16.5% for men in their 40s, 23.0% for men in their 50s, 28.9% for men in their 60s, and 37.2% for men older than 70 years of age
  • The prevalence of hypogonadism among men in Taiwan is higher than the prevalence reported in the Massachusetts Male Aging Study
  • CAG repeat sequence, within the androgen receptor (AR). Rajender et al[12] reviewed over 30 studies on the AR trinucleotide repeat and infertility
  • suggestion that CAG repeat length may determine androgen responsiveness, this issue is not clearly settled
  • reported prevalence of low T in older men range from 5.6% to 50%
  • Those in the hypogonadal group (n = 4269) had direct health care costs, that exceeded the eugonadal group (n = 4269) by an average of $7100 over the course of the observation window
  • higher economic burden and presence of co-morbidities for hypogonadism
  • minor to moderate improvements in lean mass and muscle strength
  • increased bone mineral density
  • modest enhancement in sexual function
  • reduced adiposity
  • lessening of depressive symptoms
  • Meta-analyses of clinical TRT trials as of 2010 have identified three major adverse events resulting from TRT: (1) polycythemia; (2) an increase in prostate-related events; and (3) and a slight reduction in serum high-density lipoprotein (HDL) cholesterol
  • polycythemia (> 3.5-fold increase in risk
  • TRT produced a 40% prostate enlargement in older hypogonadal male Veterans over 12 mo
  • no published analysis has reported measurable increases in prostate cancer risk or Gleason score in men undergoing TRT, or in hypogonadal men with a history of prostate cancer undergoing TRT
  • the prostate which highly expresses the type II 5α-reductase enzyme. Inhibition of this enzyme via finasteride (a type II 5α-reductase inhibitor) or dutasteride (a dual type I and II 5α-reductase inhibitor) reduces circulating DHT 50%-75% and > 90%, respectively[47], and reduces prostate mass[48] and prostate cancer risk
  • Normally estradiol partially regulates testosterone levels, at the hypothalamus, blunting LH and FSH release from the pituitary. As a selective estrogen receptor modulator, CC interrupts this pathway, and consequently there is a greater stimulation for the production of testosterone in Leydig cells
    • Nathan Goodyear
       
      this would only apply if E1 and/or E2 levels were elevated, which the authors make no mention of.
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    to be read
Nathan Goodyear

A new era of testosterone and prostate cancer: from... [Eur Urol. 2014] - PubMed - NCBI - 0 views

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    The tide is beginning to shift on testosterone and Prostate Cancer.  A literature review finds no support for Testosterone and Prostate carcinogenesis or low Testosterone providing any protection against prostate cancer.  
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    a good read!
Nathan Goodyear

BMC Cancer | Full text | A lactate shuttle system between tumour and stromal cells is associated with poor prognosis in prostate cancer - 0 views

  • Under hypoxic conditions, tumour cells primarily use glycolysis for energy, producing lactate, which is expelled to the tumour microenvironment, allowing tumours to continue their glycolytic activity
  • Sonveaux et al. showed that lactate, which is generally considered a waste product, is preferred over glucose by oxidative tumour cells as their primary energy source
  • MCT4 is a low-affinity transporter, which is abundant in highly glycolytic muscle cells and is one of the many target genes of hypoxia-inducible factor 1 alpha (HIF-1α)
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  • Other targets of HIF-1α include glucose transporter-1 (GLUT-1), the main transporter involved in glucose uptake [9,10]; lactate dehydrogenase V (LDHV), which is responsible for the conversion of pyruvate into lactate; pyruvate dehydrogenase kinase isozyme 1 (PDK1), which is responsible for the phosphorylation and consequent inactivation of pyruvate dehydrogenase (PDH); and carbonic anhydrase IX (CAIX), a hypoxia-related protein involved in pH regulation [11]. Alpha-methylacyl-CoA racemase (AMACR), pristanoyl-CoA oxidase (ACOX-3) and D-bifunctional protein (DBP), are also important fatty acid oxidation-related proteins in prostate cancer
  • the essential role played by the cross-talk between stroma and epithelium in carcinogenesis and prostate cancer progression has been increasingly recognised
  • strong membranous expression of MCT1 was consistently observed in cancer cells, suggesting a role for MCT1 in the transport of lactate into tumour cells from the acidic extracellular matrix, suggesting that lactate might be used as a fuel by oxidative cancer cells.
  • Our hypothesis is in agreement with those of Fiaschi et al.[17], who describe the metabolic reprogramming of CAFs towards the Warburg phenotype as a result of contact with prostate cancer cells
  • Using in vitro studies, they showed lactate production and efflux by de novo expressed MCT4 in CAFs and also demonstrated that, upon contact with CAFs, prostate cancer cells were reprogrammed towards aerobic metabolism, with an increase in lactate uptake via the lactate transporter MCT1.
  • pharmacological inhibition of MCT1-mediated lactate uptake dramatically affected PCa cell survival and tumour outgrowth
  • In this model, “energy transfer” or “metabolic coupling” between the tumour stroma and epithelial cancer cells fuels tumour growth and metastasis via oxidative mitochondrial metabolism in anabolic cancer cells
  • the concomitant expression of MCT1 in tumour cells and MCT4 in fibroblasts in the same tissue is clinically significant, and associated with poor prognosis.
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    Study confirms the importance of the crosstalk between cancer cells and CAFs via MCTs in prostate cancer.
Nathan Goodyear

Prostate Biopsy in Response to a Change in Nadir Prostate Specific Antigen of 0.4 ng/ml after Treatment with 5α-Reductase Inhibitors Markedly Enhances the Detection Rate of Prostate Cancer - The Journal of Urology - 0 views

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    5 alpha reductase inhibitor therapy reduces PSA and prostate volume.  The level of change may be used to aid in prostate cancer diagnosis.  Those with eventual diagnosis had Gleason 7 or higher.
Nathan Goodyear

Immunotherapy for Prostate Cancer with Gc Protein-Derived Macrophage-Activating Factor, GcMAF - Europe PMC Article - Europe PMC - 0 views

  • the MAF precursor activity of prostate cancer patient Gc protein is lost or reduced, because their serum Gc protein is deglycosylated by serum α-N-acetylgalactosaminidase (Nagalase) secreted from cancerous cells
  • Administration of 100 ng of GcMAF
  • 100 ng of GcMAF was administered intramuscularly once a week
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  • As GcMAF therapy progressed the MAF precursor activity of all five patients increased and their serum Nagalase activity decreased inversely
  • As GcMAF therapy progressed, the MAF precursor activity increased with a concomitant decrease in serum Nagalase activity
  • serum Nagalase is proportional to tumor burden
  • as GcMAF therapy progressed, serum Nagalase activity decreased and, concomitantly, tumor burden decreased
  • the serum Nagalase activities of all 16 patients decreased as GcMAF therapy progressed
  • annual computed tomographic scans of these patients confirmed them being tumor recurrence-free for the 7 years
  • undifferentiated cells were killed rapidly during the first few weeks, and the differentiated cells were killed slowly in the remaining GcMAF therapeutic period
  • PSA levels of prostatectomized patients decreased as serum Nagalase decreased during GcMAF therapy
  • In patients without tumor resection, however, although serum Nagalase activity decreased as GcMAF therapy progressed, their PSA values remained unchanged. The result suggests that the PSA derived from tumor-bearing prostate did not change while tumor burden decreased. Because tumor-induced inflammation in the noncancerous prostate tissues causes secretion of PSA [38], the PSA produced from these inflamed noncancerous prostate tissues cannot be changed by the decrease in tumor burden
  • Advanced cancer patients have high serum Nagalase activities, resulting in no macrophage activation and severe immunosuppression that explain why cancer patients die with overwhelming infection
  • Prognostic utility of serum α-N-acetylgalactosaminidase and immunosuppression resulted from deglycosylation of serum Gc protein in oral cancer patients
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    GC-MAF levels exist in inverse relationship to nagalase.  In this study of men with prostate cancer, weekly GCMAF injections reduced Nagalase activity to levels found in healthy controls suggesting tumor free. The dose was 100 ng/week. Nagalase is a protein that suppresses GC-MAF production and thus is immunosuppressive.
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