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Testosterone ratio to Estrogen and risk of prostate cancer.
I am a 47 year old man with prostate cancer which was discovered 18 months ago. My cancer is t2 Gleason 3+3. My doctor initially reccomended I get surgery within 3 months.
I have choose watchful waiting and went on non fat, non dairy no read meat diet. I love Pomegranates so I had no trouble adding that as well.
I have had all sorts of blood work which has revealed nomal body levels in everything but vitaman B and Testosterone.
Originally I had been told never to replace the testosterone as it would fuel the cancer. As I researched the subject and consulted an every increasing circle of doctors it seems that theory is under much debate.
I have read and point out to my internal medicine doctor a study I saw that said Testosterone was not the problem, it was the ratio of testosterone vs Estrogen in men that could cause prostate cancer in the first place.
My new doctor knew of the study and agreed saying the people with the highest levels of testosterone namely young men, don't have prostate cancer.
Adding to that the research that indicates men with lower levels of testosterone are at greater risk makes me wonder why hormone replacement was not more obvious sooner.
Long story short is that my PSA has decrease from 5.5 to 1.8 to 1.7 to 1.6 most recently. I have had a B1 shot and subject to one more PSA, we will try HGH.
I would like to know if others have heard of the study. Oh and by the way, my first doctor who suggested I rush into surgery now says he is glad I waited.
Re: Testosterone ratio to Estrogen and risk of prostate cancer.
Yes, I have read of this theory and it does make a good deal of sense to me. I cannot recall ever having seen a specific study that sets out the precise options and outcomes but you say you have done so.
Can you share with us the details of any relevant studies?
A change in lifestyle and dietary intervention can be instrumental in bringing down estrogen levels.
Testosterone replacement might be an option at an early date. But when to start ? When you are thirty or thirty-five?
After PCa has been diagnosed it should not be considered, especially single handedly without guidance by a physician. And you will not be able to find a responsible physician who is reckless enough to accompany you on this journey (and most probably lacks the know how). Unless you contact Dr. Bob (Leibowitz), the maverick oncologist who is years ahead of his time. Of course his treatment is costly, but he has been working with high dose testosterone for years, always after HB, chemo with Taxotere/Emcyt/Carboplatin, and his anti-angionesic cocktail. But see for yourself: http://compassionateoncology.org/pdfs/TRTcase_reports-05-09.pdf
Re: Testosterone ratio to Estrogen and risk of prostate cancer.
Josh,
Those are not studies, they are sites where statements are made that have no back-up to demonstrate they are correct.
For example, the first link you gave to HOW MEN CAN AVOID ESTROGEN DOMINANCE opens with this statement - I have created the emphasis In men, the condition known as estrogen dominance MAY LEAD TO infertility, breast development, even CANCER. Note the "MAY LEAD" and "even Cancer" - not too definite.
So, where is there any back-up for this statement. I couldn't find anything worthwhile and of the three links given to support the theory stated in the article, the middle one took me to a bingo site. The first was to a page about the problems WOMEN have with estrogen dominance and the third to Dr. HingHau Tsang's Crusade on Nutrition . On this page the good dcotor refers to Research Studies, almost all of which refer to animal studies and most of which are undated - the one for which he does give a date was done more than 21 years ago.
As I say, I think the theory makes a good deal of sense and it has since I first came across it many years ago, BUT.....why is there no good research?
Re: Testosterone ratio to Estrogen and risk of prostate cancer.
Terry,
I thought this article explains estrogene dominance in easy understandable language, just to give an idea of what estrogene dominance is about, so people would be intrigued to do some further research. Of course this kind of article is never free of conflict of interest.
Nevertheless, the fact of estrogene dominance cannot be ignored. We just have to compare the estrogene/ testosterone ratios of males in different age groups and bingo (forgive the pun). When under androgene ablation this imbalance is naturally more pronounced. In healthy males progesterone could be given to correct this, but for men with systemic disease on ADT it would be sensible to try lowering their estrogene level.
The environmental aspect of estrogene dominance also seems to be widely recognized. Other contributing factors are individual metabolism and obesity, for example.
For about ten years it is known, that the estrogene receptors beta and alpha are involved in PCa, the first beneficial in early stage, the second detrimental in late stage of disease. There are the SERM drugs Toremifene and Raloxifene indicated for breat cancer, but unfortunately not for prostate cancer, although there are indications that they could be effective in suppressing estrogene rezeptor alpha. Well, maybe in ten years time there will be some evidence.
The current androgene ablation therapy is antiquated and inadequate. It leads to castrate resistance, if lucky to a second-line therapy if your uro/onco is up to speed, and chemo with an avarage additional life expectancy of three months, side effects thrown in for free. LOL
Anyway, these links are hopefully more enlightening than the previous ones.
Re: Testosterone ratio to Estrogen and risk of prostate cancer.
Josh,
I have to say I do get a little irritated when I see statements like the one below with no reference or attribution:
The current androgene ablation therapy is antiquated and inadequate. It leads to castrate resistance, if lucky to a second-line therapy if your uro/onco is up to speed, and chemo with an avarage additional life expectancy of three months, side effects thrown in for free.
Can I ask where you got that information from? Just the Abstract of the relevant will do, as opposed to a webpage making the claim without reference.
Re: Testosterone ratio to Estrogen and risk of prostate cancer.
Terry,
Your irritation noted. The terms "antiquated" and "inadequate"(I suppose they are the ones that irk you)are based on my own experience of a 6 year struggle, 6 years work in a support group of men with high risk PCa, relevant literature, a very lively forum with some outstanding, critical minds, and internet.
Let me quote from a paper by Prof.H.Bonckhoff, a well-known pathologist: " The clinical courses of the prostate carcinoma are highly varied, the phase of androgen resistance however is relatively short and leads to death in an average of 9 to 27 months. In basic reaearch there is an abundance of data suggesting that behind this clinical androgen resistance a multi factoral disease is hidden, and that the causative factors are partly-a long time before clinical manifestation-present and evident.
Androgen deprivation has been the therapeutic standard in the treatment of the metastatic PCa for over 60 years. There are new perceptions as to why this initially successful therapy leads to androgen resistance in most cases. According to the present understanding of the development of clinial androgen resistance the following patho-mechanism play a role:
Hypersensitive androgen receptor (hypersensitive pathway)
Mutation within androgen receptor (promiske ligands)
Ligand-independent activation of the androgen receptor by growth factors and their receptors (outlaw pathways)
Bypass of androgen receptors (bypass pathway)
Recapitulation of stemm cell characteristics
Already in normal prostate epithel cell populations are found that are endowed with a distinct resistance toward androgen deprivation, radiation therapy and cytostatic chemo therapy. Therefore it is not surprising that the hormone refractory PCa recapitulates the biological characteristics of these cells.
(Unfortunately there is no English version)
Accordingly Prof. Bonckhoff can predict from markers in biopsy material whether a certain therapy will work or not. We have put it to the test, and it works. But of what use is this, if nobody knows about it. Ask your average urologist and watch his reaction. http://www.prostapath.org/
People with high Gleason and PSA are being treated with a therapy that is initially successful, passes over to androgen resistance after 2 years or so, and is then being treated with drugs that are-except Taxotere-on the market for twenty years or more.
If you look at the advances made in diagnostic, surgery, radiation therapies and compare it with hormonal therapies, the latter is really the poor relativ.
The nature of averages is that there is always winners and losers. We should always keep this in mind.
My criticism may seem a bit harsh, but if we don`t raise our voice sometimes there will be no change. I think the transition of knowledge to therapies is too slow, as most of us don`t have the time to wait for years and years.
Anyway, I think there will be a paradigm change concerning estrogens and testosterone in the treatment of PCa
Hormonal therapy isn´t so bad, but I think it could be better. Without it I wouldn`t be around anymore and I am very grateful that there is a system with dedicated people who are doing a great job and have accompanied me on the way in a very difficult phase of my life.
On a rainy day or in a sleepness night I would like to ask everyoneto visit the site of PCRI and find out as much as you can about our unwelcome guest.
Re: Testosterone ratio to Estrogen and risk of prostate cancer.
No Josh, you misunderstand me.
I have no issue with anyone who regards current diagnostic and treatment procedures as antiquated and inadequate, because many of them are indeed just that.
I also have no issue about criticism and agree fully that if we don’t raise our voice sometimes there will be no change. I have been criticising the diagnostic and treatment procedures ever since I learned enough to know what damage they do to so many men unnecessarily, while taking the focus away from areas where the resources would be better spent. Which is to say if less of the time and money of the PCa industry was concentrated on damaging men who need no treatment, more time and money could be spent on finding how to identify aggressive disease more precisely and how to deal with the consequences of those aggressive forms of the disease.
So, what was I referring to? It was this [edited for focus]:
The current androgene ablation therapy …. leads to castrate resistance, … to a second-line therapy …. and chemo with an avarage additional life expectancy of three months, ……..
How do you think people like Amado, and others who are concerned about a failed treatment or a late diagnosis feel when they are told that they will only have an additional life expectancy of three months?
So I asked you for a reference to justify your statement and in reply you quote H. Bonckhoff, who you say is a pathologist, not an oncologist, as saying in part:
The clinical courses of the prostate carcinoma are highly varied, the phase of androgen resistance however is relatively short and leads to death in an average of 9 to 27 months.
Well, looks like an improvement on 3 months additional life expectancy, but even then it is not helpful to people who don’t understand fully the concept of ‘average’ and ‘median’ and the importance of ‘range’ I was one of those people until I read that great piece by Stephen Jay Gould THE MEDIAN ISN’T THE MESSAGE He was diagnosed with a disease that had a median mortality of eight months and he lived 20 years. There are many men who have failed ADT (Androgen Deprivation Therapy) and move to chemotherapy who live a good deal longer than 3 months, 9 months or even 27 months and I believe that men who are considering these therapies should be told the range of life expectancy, including the short end, not the median or worse still, the average.
So now you know why I was irritated by part of your post.
Good luck to you and all your compadres as you try to change the world. On our first visit to the US we went to Arlington and we saw Bobby Kennedy’s memorial with these words:
It is from numberless acts of courage and belief that human history is shaped. Each time a man stands up for an ideal or acts to improve the lot of others or strikes out against injustice, he sends forth a tiny ripple of hope and crossing each other from a million different centres of energy and daring, those ripples build a might current that can sweep down the mightiest walls of oppression and resistance.
I found it very moving – we can all make a difference.
Re: Testosterone ratio to Estrogen and risk of prostate cancer.
Terry,
I get what you mean. And thank you for the link on S.J.Gould, it is an eye-opener. I never looked at it from his angle. Well, you are never too old to learn.
Prof B. may be "only" a pathologist, but he is a capacity with a profound understanding of prostate cancer, and his assessment by looking at certain markers can, in conjunction with a urologist/oncologist, prevent those trial and error therapies we often see. Even years after an ongoing therapy fails, a look at newly obtained tissue may be useful for a new therapy decision.
Re: Testosterone ratio to Estrogen and risk of prostate cancer.
I'm really going out on a limb here, so much so that I risk being drummed out of the forum, but here goes. I recall reading, from a source that I can't judge was credible or incredible, that the ratio between Testosterone and and Estrogen should be 200 to 1, but for the life of me I can't recall which is which.
Re: Testosterone ratio to Estrogen and risk of prostate cancer.
Jack,
You'd be a first if your were 'drummed out of this forum' - well apart from a couple of snake oil salesmen who got through the bulltish filter. The rules are simply set out above and you haven't broken any of them - yet:-)
I must say that I have never seen any good studies that demonstrate clear relationships between Testosterone and Estrogen, breaches of which lead to identifiable consequences.
There may be such studies and if you can track them down and share them with us, you will have helped to advance our collective knowledge.
Re: Testosterone ratio to Estrogen and risk of prostate cancer.
Maybe I can redeem myself with this information. In the following site,
testosteronewisdom.com, I see that, assuming a normal level of Testosterone of 300-1000 ng/dl, the level of estradiol, a marker for estrogen, should be between 14-54 pg/ml. I understand that DHEA converts to testosterone as well as estrogen. I wonder if this conversion provides the correct ratio.
Re: Testosterone ratio to Estrogen and risk of prostate cancer.
Sorry Jack, I do not have the time to read right through the site to find the figures you mention, but doubt very much, looking at other aspects of the site that there would be any good data to show a link between T/E levels and PCa.
But even if it was, is the ratio 14/300 or 14/1000 or 54/300 or 54/1000?Those are two wide ranges to draw firm conclusions in my opinion.
I see the author of the site is described as
Nelson Vergel is a 25+ year long term HIV survivor. Aided by his chemical engineering degree and obsession for scientific data, he adds his own personal experience as he demystifies many health myths. For the last 20 years, his trial-and-error experience to improve his quality of life has paved the way for others to learn from his knowledge.
Personal trial-and-error experiments, while interesting, are rarely sound bases for making sound decisions - especially when these experiments are the basis for selling anything - like a book or.....
Re: Testosterone ratio to Estrogen and risk of prostate cancer.
This is from a blog on the site,wwwtestosteronewisdom.com. Elsewhere there is a mention of using T replacement with caution in cases of Pca.
The normal production ratio of testosterone to estrogen is approximately 100:1. The normal ratio of testosterone to estrogen in the circulation is approximately 300:1. Estrogen (measured as estradiol) should be kept at 30 picograms per milliliter (pg/mL) or lower. As men grow older or as they gain a lot of fat mass, their estrogen blood levels increase, even to levels higher than that of postmenopausal women.
This is a site which speaks of a small study which suggests that use of estradiol reduces testosterone with fewer risks for osteoporosis and heart problems and, while enlarged breasts still occur, men had fewer complaints regarding hot flashes. That brings to mind the videos I've seen of Dr. Meyers. Maybe I got it all wrong, but it seems he promotes the use of estradiol and Testosterone therapy at the same time. I hope someone can clear this up for me. My primary doctor practices integrative medicine and we kicked around the idea of T. replacement. My urologist said my testosterone will go up now that I'm 'on vacation' from my injections. I decided to take DHEA, which converts to testosterone and estrogen, and my primary doctor has no problem with that.
Aloha,
Have you been following Ralph Valle comments? I asked Mike where these articles were located and he gave me
http://www.ncbi.nlm.nih.gov/sites/entrez
Using "Testosterone Prostate Cancer" brings up many abstracts.
Here are 3 that I found in the first few pages;
Future Oncol. 2009 Sep;5(7):1005-13.
Association between serum sex hormone levels and prostate cancer: effect of prostate cancer on serum testosterone levels.
ScientificWorldJournal. 2009 Jul 27;9:685-90.
Rapidly shifting concepts regarding androgens and prostate cancer.
J Steroid Biochem Mol Biol. 2009 Mar;114(1-2):96-105. Epub 2009 Jan 30.
Testosterone deficiency syndrome: treatment and cancer risk.
Joe
