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Query: UMLS:C0376358 (prostate cancer)
 59,338 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The androgen receptor mediates the androgenic and anabolic activity of the endogenous steroids testosterone and 5alpha-dihydrotestosterone. Current knowledge of the androgen receptor protein structure, and the molecular mechanisms surrounding the binding properties and activities of agonists and antagonists has led to the design and development of novel nonsteroidal ligands with selected tissue-specific androgen receptor agonist and antagonist activities. The activity of these compounds, termed selective androgen receptor modulators (SARMs), is directed toward the maintenance or enhancement of anabolic effects on bone and muscle with minimal androgenic effects on prostate growth. SARMs are of potential therapeutic value in the treatment of male hypogonadism, osteoporosis, frailty and muscle wasting, burn injury and would healing, anemia, mood and depression, benign prostatic hyperplasia and prostate cancer.
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PMID:Selective androgen receptor modulators: in pursuit of tissue-selective androgens. 1708 31

Ageing of the male reproductive system is characterized by changes in the endocrine system, hypogonadism, erectile dysfunction and proliferative disorders of the prostate gland. Stochastic damage accumulating within ageing leads to progressive dysregulation at each level of the hypothalamic-pituitary-gonadal (HPG) axis and in local auto/paracrine interactions, thereby inducing morphological changes in reproductive target organs, such as the prostate, testis and penis. Despite age-related changes in the HPG axis, endocrine functions are generally sufficient to maintain fertility in elderly men. Ageing of the male reproductive system can give rise to clinically relevant manifestations, such as benign prostatic hyperplasia (BPH), prostate cancer (PCa) and erectile dysfunction (ED). In this review, we discuss morphological/histological changes occurring in these organs and current views and concepts of the underlying pathology. Moreover, we emphasize the molecular/cellular pathways leading to reduced testicular/penile function and proliferative disorders of the prostate gland.
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PMID:The ageing male reproductive tract. 1720 Sep 38

In recent years, osteoporosis in men has become increasingly recognized as an important clinical and public health problem. Many similarities exist in various aspects of osteoporosis in men and women, but this article focuses on the sex difference, bone biology, epidemiology, and consequences of fractures. Although maintenance of bone integrity depends on the action of sex hormones in both sexes, menopause is a much more obvious indicator of estrogen deficiency than is the subtle decrease of testosterone in aging men. This often leads to delay and neglect of diagnosis. The need to identify and screen men at a particular risk for osteoporosis, as when hypogonadism is induced for treatment of prostate cancer, has become important.
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PMID:Hypogonadal hypogonadism and osteoporosis in men. 1727 May 93

Klinefelter syndrome is a common cause of hypogonadism. Testosterone replacement therapy has beneficial effects on bone, muscle and psychosexual function. However, it may remove the relative protection from adenocarcinoma of prostate, which is otherwise rare in uncomplicated Klinefelter syndrome. We report the case of a 55-year-old man with Klinefelter syndrome who developed prostate cancer after only 7 years of androgen supplementation. Androgen deprivation therapy was complicated by the presence of testosterone implants. The patient was treated with androgen blockade followed by radiation therapy. We recommend that serum prostate specific antigen (PSA) and digital rectal examinations be carried out during, as well as before androgen replacement.
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PMID:Prostate cancer following testosterone replacement in Klinefelter syndrome. 1729 32

A 2003 report by the Institute of Medicine (IOM) surveyed the literature on the benefits and risks of testosterone replacement therapy in older men and identified knowledge gaps and research needs. This review summarises some key studies published since the IOM report. The possible relationship of testosterone to risk of prostate cancer remains a concern; however, no new evidence has emerged to suggest that testosterone replacement therapy increases the risk. Recent studies have demonstrated that hypogonadism in men may be more prevalent than previously thought, is strongly associated with metabolic syndrome, and may be a risk factor for type 2 diabetes and cardiovascular disease. Clinical studies have shown that testosterone replacement therapy in hypogonadal men improves metabolic syndrome indicators and cardiovascular risk factors. Maintaining testosterone concentrations in the normal range has been shown to contribute to bone health, lean muscle mass, and physical and sexual function, suggesting that testosterone replacement therapy may help to prevent frailty in older men. Based on current knowledge, testosterone replacement therapy is unlikely to pose major health risks in patients without prostate cancer and may offer substantial health benefits. Larger, longer-term randomised studies are needed to fully establish the effects of testosterone replacement therapy.
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PMID:Testosterone and ageing: what have we learned since the Institute of Medicine report and what lies ahead? 1739 25

The number of men for whom testosterone is prescribed is rapidly increasing. The aging man normally demonstrates a gradual decline in testosterone. Symptoms of hypogonadism include erectile dysfunction, diminished libido, sarcopenia, increased adiposity, osteopenia and osteoporosis, impaired cognition, and depression. There is a paucity of data regarding both efficacy and safety of testosterone replacement therapy. Testosterone levels have been shown to modulate prostate cancer risk and progression. A prospective evaluation of prostate cancer risk with testosterone replacement therapy has not been conducted. We outline concerns and recommendations for the use of testosterone replacement therapy in the aging man.
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PMID:Testosterone replacement therapy and prostate cancer: a word of caution. 1745 66

This paper deals with some of the musculo-skeletal complication that can occur after cancer treatment. In particular, we focus on Cancer Treatment Induced Bone Loss (CTIBL) and the musculo-skeletal complications that can occur in patients treated for extremity sarcoma. In addition we discuss peripheral neuropathy, musculo-skeletal pain and briefly mention some of the complications related to radiotherapy. CTIBL is mostly studied in breast cancer and prostate cancer survivors. The cause in these groups is mainly due to treatment induced hypogonadism. Other causes of CTIBL are indirect or direct cause of chemotherapy, physical inactivity and inadequate intake of vitamin D and calcium. Treatment of CTIBL consists of diet and lifestyle changes and pharmacological intervention. Extremity bone sarcomas constitute a special group since they often experience mutilating surgery and heavy combination chemotherapy. The treatment results in worse function than the normal population and the amputated usually have lower physical functioning than patients treated with limb sparing surgery (LSS). However, most studies fail to show differences in quality of life between the amputated and LSS. Most of the studies performed on musculo-skeletal sequelae have been done on survivors of childhood cancer, breast cancer or prostate cancer. More studies among the other cancer groups are needed to reveal the extent and prevalence of these complications.
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PMID:Some musculo-skeletal sequelae in cancer survivors. 1749 16

Hypogonadism in men has a complex and varied pathogenesis. In addition to multiple established causes of the disease, low testosterone levels are associated with various comorbidities, including metabolic syndrome and type 2 diabetes. Symptoms associated with hypogonadism include reduced sex drive, fatigue, and mood disturbances, but accurate diagnosis requires biochemical testing. Total testosterone is considered the appropriate testosterone measurement in most situations in primary care, although free testosterone is a more accurate marker and is indicated in some situations. Testosterone replacement therapy is a valid treatment option for men with testosterone deficiency accompanied by symptoms of hypogonadism. The goals of therapy are to restore physiologic testosterone levels and alleviate symptoms. A potential association of testosterone replacement therapy with prostate cancer is the biggest safety concern, so patient monitoring should include regular digital rectal examination and prostate-specific antigen tests.
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PMID:Evolving issues in male hypogonadism: evaluation, management, and related comorbidities. 1754 24

Osteoporosis has long been recognized as a disease affecting postmenopausal women but it has become increasingly clear that men are affected by low bone density and suffer the consequences of osteoporotic fractures. Men attending clinical urological practices might be at raised risk of bone loss due to hypogonadism, either identified during work-up of erectile dysfunction or induced by androgen deprivation therapy for treatment of prostate cancer. The availability of bisphosphonate drugs with proven efficacy in fracture reduction has revolutionized osteoporosis therapy in the past decade. The use of these agents has been traditionally based on data obtained predominantly from postmenopausal women and cases of glucocorticoid-induced osteoporosis, but data are becoming increasingly available to justify their use in men. Despite the availability and favorable safety profile of bisphosphonates, many patients are not receiving therapy. This article serves to review the data regarding bisphosphonate use in men, discussing particularly the pharmacology and mechanisms of action of these agents, and findings from clinical studies supporting their use for fracture prevention.
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PMID:Drug insight: the use of bisphosphonates for the prevention and treatment of osteoporosis in men. 1755 35

Androgen replacement therapy (ART) should be considered for initial treatment of late-onset hypogonadism. Intramuscular injection of testosterone enanthate is frequently used for ART in Japan. Prior to ART, it is necessary to measure prostate specific antigen (PSA) in order to rule out prostate cancer, and hematological examination should be performed periodically during treatment to monitor for polycythemia.
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PMID:[Hormone replacement Up-to-date. Clinical practice of androgen replacement therapy]. 1776 32


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