Attn: Will Brink

re your Intake Update column in the December 2006 issue of MMI, you
might want to review:

Testosterone therapy linked to prostate cancer?
Small study finds male hormone supplementation associated with disease

NEW YORK - Prostate cancer developed in 20 men within months to a few
years after they began testosterone supplementation to correct a
deficiency of the hormone, investigators report.

"There are several anecdotal case reports, small studies, and
observational studies like ours which raise concern but do not provide
conclusive evidence yet," Dr. Franklin D. Gaylis told Reuters Health.

The issue is a concern because prostate cancer is usually driven by
testosterone.

Gaylis, from the University of California at San Diego Medical Center,
and colleagues report this series of patients "in whom clinically
significant prostate cancer developed and was presumed to be related to
exogenous testosterone use," in the Journal of Urology.

The men were identified in six different urology practices. Prostate
cancer was detected within 2 years of the start of testosterone
replacement in 11 of these men, seven of them within the first year,
the authors report. The others were diagnosed after 28 months to 8
years.

Eleven men had normal prostate exams before testosterone
supplementation was begun, the report indicates, and the average PSA
level of the 17 men tested before treatment was 3, although the range
was 0.9 to 15. The threshold for further evaluation is usually 4.

A 'shot across the bow'
"It is our belief that men, especially those with a family history of
prostate cancer, should not receive a prescription for testosterone
supplementation without careful, informed consultation regarding the
risks and benefits of such treatment," the investigators conclude.

"I would hope that guidelines would be developed by experts in the
field to help us appropriately and carefully prescribe testosterone
replacement to men who clearly need it and who would benefit from it,
and then monitor them for potential adverse outcomes, e.g., the
development of prostate cancer," Gaylis said.

While the study has flaws, writes Dr. E. Darracott Vaughan, Jr. from
Weill Medical College of Cornell University, New York, in a related
editorial, it "can be taken as a 'shot across the bow' for urologists
and other physicians. We need to be extremely careful before beginning
testosterone therapy." From http://www.msnbc.msn.com/id/8929678/

--
Curt