Jacob Rajfer, M.D., Professor of Urology, UCLA School of Medicine
“Best of AUA, 2006” (From
MedReviews, Summer 2006)
"In support of
androgen replacement therapy in aged men, Marks and colleagues from
the University of California, Los Angeles gave what this reviewer considered
to be one of the most elegant talks about this topic.
Marks, in collaboration with experts from all over the United States,
gave middle-aged patients placebo or testosterone daily for 6 months
and performed prostate biopsies biopsies before and after cessation
of testosterone therapy.
No difference in the incidence of carcinoma of the prostate was found
between the placebo and testosterone therapy groups, and levels of testosterone
and dihydrotestosterone within the prostate tissue also were no different
between the 2 groups.
In addition, Mostaghel and colleagues21 found that the genes that promote
or represent prostatic growth (eg, prostatespecific antigen [PSA]) were
not stimulated more in the testosterone group than in the placebo group.
The investigators suggested that the effects of exogenous androgens
are "buffered" by the prostate and that the long-held belief that exogenous
androgens are stimulatory when given to aged men needs to be re-examined."
Alvaro Morales, M.D., Professor of Urology, Queens University,
Kingston, Ontario, Canada.
Prostate Health," European Urology 50: 895, 2006
“Finally, to further complicate the picture, fascinating and
convincing evidence has been presented lately demonstrating that ‘‘no
prostate tissue changes attributable to T supplementation were found
(in this study of men with low T receiving T supplementation).
Despite marked increases in serum levels, prostate levels of T and
DHT were unchanged after 6months of treatment, gene expression was not
altered, cell proliferation was not accelerated, and histologic cancers
were not increased’’. Thus, it appears that the intraprostatic
hormonal environment bears little resemblance to serum levels of androgens.
The implications of these findings, once confirmed, are of enormous
Michael O’Leary, M.D.,
Professor of Urology, Harvard Medical School, Boston.
"Highlights of 2006 AUA Meeting"
"Now what about
the effects of testosterone in the prostate? This (paper) gets my personal
vote, if I have to give one, as probably one of the best papers of all
of the sessions that I reviewed."
LISTEN TO PROFESSOR O'LEARY REVIEW THE PAPER