Medical Forum / General / General / December 2004
Testosterone added to Estrogen/Progestin Therapy reduces breast cancer risk toward baseline
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William_Noyes - 02 Dec 2004 22:26 GMT This isn't the only piece of evidence of the value of androgens/testosterone therapy in women. But it makes it clear the testosterone isn't only about sexual pleasure but also about life. If ERT regimens were no longer a risk breast cancer, they'd be more useful. Even taken alone androgen therapy for some women appears useful.
Please consider the following and comment:
2: Menopause. 2004 Sep-Oct;11(5):531-5.
Breast cancer incidence in postmenopausal women using testosterone in addition to usual hormone therapy.
Dimitrakakis C, Jones RA, Liu A, Bondy CA.
Developmental Endocrinology Branch, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20892, USA.
OBJECTIVE: There is now convincing evidence that usual hormone therapy for ovarian failure increases the risk for breast cancer. We have previously shown that ovarian androgens normally protect mammary epithelial cells from excessive estrogenic stimulation, and therefore we hypothesized that the addition of testosterone to usual hormone therapy might protect women from breast cancer.
DESIGN: This was a retrospective, observational study that followed 508 postmenopausal women receiving testosterone in addition to usual hormone therapy in South Australia. Breast cancer status was ascertained by mammography at the initiation of testosterone treatment and biannually thereafter. The average age at the start of follow-up was 56.4 years, and the mean duration of follow-up was 5.8 years. Breast cancer incidence in this group was compared with that of untreated women and women using usual hormone therapy reported in the medical literature and to age-specific local population rates.
RESULTS: There were seven cases of invasive breast cancer in this population of testosterone users, for an incidence of 238 per 100,000 woman-years. The rate for estrogen/progestin and testosterone users was 293 per 100,000 woman-years--substantially less than women receiving estrogen/pro-gestin in the Women's Health Initiative study (380 per 100,000 woman-years) or in the "Million Women" Study (521 per 100,000 woman-years). The breast cancer rate in our testosterone users was closest to that reported for hormone therapy never-users in the latter study (283 per 100,000 woman-years), and their age-standardized rate was the same as for the general population in South Australia.
CONCLUSIONS: These observations suggest that the addition of testosterone to conventional hormone therapy for postmenopausal women does not increase and may indeed reduce the hormone therapy-associated breast cancer risk-thereby returning the incidence to the normal rates observed in the general, untreated population.
PMID: 15356405 [PubMed - in process]
Pubmed search words were "estrogen testosterone cancer" as I recall. I may have also used the word "therapy", "androgens", and "breast" in related searchs.
James Michael Howard - 02 Dec 2004 22:43 GMT >This isn't the only piece of evidence of the value of androgens/testosterone >therapy in women. But it makes it clear the testosterone isn't only [quoted text clipped - 63 lines] >as I recall. I may have also used the word "therapy", "androgens", >and "breast" in related searchs. I would be careful giving testosterone to women: This is just a sample. Look between the ****** below.
Int J Cancer. 2005 Jan 20;113(3):499-502. Related Articles, Links
Serum testosterone levels and breast cancer recurrence.
Berrino F, Pasanisi P, Bellati C, Venturelli E, Krogh V, Mastroianni A, Berselli E, Muti P, Secreto G.
Department of Preventive and Predictive Medicine, Istituto Nazionale Tumori, Milan, Italy.
Prospective studies show that high serum levels of androgens and estrogens are associated with increased incidence of postmenopausal breast cancer. The aim of the present analysis was to study the prognostic value of serum testosterone, estradiol and related factors in postmenopausal breast cancer patients. One hundred and ten patients without clinical recurrence were included in the study. After 5.5 years of follow-up, 31 patients developed distant metastasis (16), local relapse (4), or contralateral breast cancer (11). The risk of adverse events in relation to hormone level was examined by Cox' proportional hazard modeling, adjusting for hormone receptor status and stage at diagnosis. Body mass index and serum levels of testosterone, estradiol and glucose were significantly higher in patients who recurred than those who did not. The hazard ratios were 1.8 (95% CI = 0.5-6.3) for the middle and 7.2 (95% CI = 2.4-21.4) for the upper tertiles of baseline testosterone distribution. Other hormones had only minor influence on prognosis. ******High testosterone predicts breast cancer recurrence.****** Further studies are required to determine whether dietary or other medical intervention to reduce testosterone can reduce the recurrence of breast cancer.
Int J Cancer. 2004 Nov 1;112(2):312-8. Related Articles, Links
Endogenous sex hormones and subsequent breast cancer in premenopausal women.
Micheli A, Muti P, Secreto G, Krogh V, Meneghini E, Venturelli E, Sieri S, Pala V, Berrino F.
Unita di Epidemiologia, Istituto Nazionale per lo Studio e la Cura dei Tumori, Milano, Italy.
Because of large intra-individual variation in hormone levels, few studies have investigated the relation of serum sex hormones to breast cancer (BC) in premenopausal women. We prospectively studied this relation, adjusting for timing of blood sampling within menstrual cycle. Premenopausal women (5,963), recruited to the Hormones and Diet in the Etiology of Breast Tumors (ORDET) cohort study, provided a blood sample in the 20-24th day of their menstrual cycle. After 5.2 years of follow-up, 65 histologically confirmed BC cases were identified and matched individually to 4 randomly selected controls. Sera, stored at -80 degrees C, were assayed blindly for dehydroepiandrosterone sulfate, total and free testosterone (FT), androstenedione, androstanediol-glucoronide, progesterone, 17-OH-progesterone, sex hormone-binding globulin, follicle-stimulating hormone (FSH) and luteinizing hormone (LH). Fifty-five cases had information for multivariate analyses. Compared to controls, BC cases had shorter cycles and intervals between blood sampling and bleeding, and lower LH and FSH. FT was significantly associated with BC risk: relative risk (RR; adjusted for age, body mass index and ovarian cycle variables) of highest vs. lowest tertile was 2.85 [95% confidence interval (CI) = 1.11-7.33, p for trend = 0.030]. Progesterone was inversely associated with adjusted RR for highest vs. lowest tertile of 0.40 (95% CI = 0.15-1.08, p for trend = 0.077), significantly so in women with regular menses, where adjusted RR was 0.12 (95% CI = 0.03-0.52, p for trend = 0.005). *****These findings support the hypothesis that ovarian hyperandrogenism associated with luteal insufficiency increases the risk of BC in premenopausal women.***** Copyright 2004 Wiley-Liss, Inc.
William_Noyes - 02 Dec 2004 23:07 GMT It would wise to check for elevated androgen levels. The idea with androgen therapy is to replace it up to normal healthy young adult levels. And the androgen may not need to be teostosterone. It may also be that unopposed T therapy has some downsides as does unopposed E therapy has some downsides.These downsides are apparently neutralized with concurrent E and T therapy at least in some.
> I would be careful giving testosterone to women: This is just a > sample. Look between the ****** below. [quoted text clipped - 68 lines] > insufficiency increases the risk of BC in premenopausal women.***** > Copyright 2004 Wiley-Liss, Inc. William_Noyes - 02 Dec 2004 22:48 GMT This isn't the only piece of evidence of the value of androgens/testosterone therapy in women. But it makes it clear the testosterone isn't only about sexual pleasure but also about life. If ERT regimens were no longer a risk breast cancer, they'd be more useful. Even taken alone androgen therapy for some women appears useful.
Hormone therapy is a great idea which conventional medicine seems have gone out of it way to botch or deny. What is the systemic problem that permits this state of affairs?
Please consider the following and comment:
2: Menopause. 2004 Sep-Oct;11(5):531-5.
Breast cancer incidence in postmenopausal women using testosterone in addition to usual hormone therapy.
Dimitrakakis C, Jones RA, Liu A, Bondy CA.
Developmental Endocrinology Branch, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20892, USA.
OBJECTIVE: There is now convincing evidence that usual hormone therapy for ovarian failure increases the risk for breast cancer. We have previously shown that ovarian androgens normally protect mammary epithelial cells from excessive estrogenic stimulation, and therefore we hypothesized that the addition of testosterone to usual hormone therapy might protect women from breast cancer.
DESIGN: This was a retrospective, observational study that followed 508 postmenopausal women receiving testosterone in addition to usual hormone therapy in South Australia. Breast cancer status was ascertained by mammography at the initiation of testosterone treatment and biannually thereafter. The average age at the start of follow-up was 56.4 years, and the mean duration of follow-up was 5.8 years. Breast cancer incidence in this group was compared with that of untreated women and women using usual hormone therapy reported in the medical literature and to age-specific local population rates.
RESULTS: There were seven cases of invasive breast cancer in this population of testosterone users, for an incidence of 238 per 100,000 woman-years. The rate for estrogen/progestin and testosterone users was 293 per 100,000 woman-years--substantially less than women receiving estrogen/pro-gestin in the Women's Health Initiative study (380 per 100,000 woman-years) or in the "Million Women" Study (521 per 100,000 woman-years). The breast cancer rate in our testosterone users was closest to that reported for hormone therapy never-users in the latter study (283 per 100,000 woman-years), and their age-standardized rate was the same as for the general population in South Australia.
CONCLUSIONS: These observations suggest that the addition of testosterone to conventional hormone therapy for postmenopausal women does not increase and may indeed reduce the hormone therapy-associated breast cancer risk-thereby returning the incidence to the normal rates observed in the general, untreated population.
PMID: 15356405 [PubMed - in process]
Pubmed search words were "estrogen testosterone cancer" as I recall. I may have also used the word "therapy", "androgens", and "breast" in related searchs.
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