Рак предстательной железы: когда нужна терапия тестостероном?

Сухих С.О., Васильев А.О., Говоров А.В., Пушкарь Д.Ю. Рак предстательной железы: когда нужна терапия тестостероном? Consilium Medicum. 2018; 20 (7): 8–10. DOI: 10.26442/2075-1753_2018.7.8-10

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Sukhikh S.O., Vasilyev A.O., Govorov A.V., Pushkar D.Yu. Prostate cancer: when need testosterone therapy? Consilium Medicum. 2018; 20 (7): 8–10. DOI: 10.26442/2075-1753_2018.7.8-10

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Аннотация

Проблема дефицита тестостерона (или гипогонадизма) остается одной из актуальнейших в урологии. Известно, что дефицит тестостерона ассоциирован со снижением либидо, потерей мышечной массы и минеральной плотности костной ткани, а также с возникновением депрессивных расстройств. Низкий уровень тестостерона сочетается с увеличением инсулинорезистентности, уровня триацилглицеридов, избыточной массой тела. Тем не менее назначение заместительной гормональной терапии тестостероном часто бывает невозможно из-за опасений урологов, связанных с наличием гипотезы об определенных взаимосвязях между развитием рака предстательной железы и уровнем андрогенов.

Ключевые слова: тестостерон, терапия тестостероном, гипогонадизм, рак предстательной железы.

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The problem of testosterone deficiency (or hypogonadism) remains one of the most urgent in urology. It is known that testosterone deficiency is associated with a decrease in libido, loss of muscle mass and bone mineral density, as well as with the onset of depressive disorders. A low level of testosterone is combined with an increase in insulin resistance, a level of triacylglycerides, an excess body weight. Nevertheless, the appointment of hormone replacement therapy with testosterone is often impossible because of fears of urologists associated with the existence of a hypothesis about certain interrelations between the development of prostate cancer and the level of androgens.

Key words: testosterone, testosterone therapy, hypogonadism, prostate cancer.

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Список литературы

1. Morgentaler A. Testosterone and prostate cancer: an historical perspective on a modern myth. Eur Urol 2006; 50 (5): 935.

2. Fernández-Miró M, Chillarón JJ, Pedro-Botet J. Testosterone deficiency, metabolic syndrome and diabetes mellitus. Med Clin 2016; 146 (2): 69–73.
3. Lytton B. Prostate cancer: a brief history and the discovery of hormonal ablation treatment. J Urol 2001; 3: 37–8.
4. Surampudi PN, Wang C, Swerdloff R. Hypogonadism in the aging male diagnosis, potentials benefits, and risks of testosterone re- placement therapy. Int J Endocrinol 2012; 2 (2): 23–34.
5. SEER Cancer Statistics Factsheets: Prostate Cancer. National Cancer Institute; Bethesda, MD, USA. Available at: http://seer.cancer.gov/statfacts/html/prost.html
6. Zhou Y, Bolton EC, Jones JO. Androgens and androgen receptor signaling in prostate tumorigenesis. J Mol Endocrinol 2015; 54 (1): 15–29.
7. Huggins C, Hodges CV. The effect of castration, of estrogen and of androgen injection on serum phosphatase on metastatic carcinoma of the prostate. Cancer Res 1941; 1: 293–7.
8. Brooke GN, Bevan CL. The role of androgen receptor mutations in prostate cancer progression. Curr Genomics 2009; 10 (1): 18–25.
9. Prehn RT. On the prevention and therapy of prostate cancer by androgen administration. Cancer Res 1999; 59: 4161–4.
10. DeVore NM, Scott EE. Structures of cytochrome P450 17A1 with prostate cancer drugs abiraterone and TOK-001. Nature 2012; 22: 116.
11. Zhou Y, Otto-Duessel M, He M et al. Low systemic testosterone levels induce androgen maintenance in benign rat prostate tissue. J Mol Endocrinol 2013; 51: 143–53.
12. Traish AM, Miner MM, Morgentaler A et al. Testosterone deficiency. Am J Med 2011; 124 (7): 578–87.
13. Stattin P, Lumme S, Tenkanen L et al. High levels of circulating testosterone are not associated with increased prostate cancer risk: a pooled prospective study. Int J Can 2004; 108: 418–24.
14. Yassin D-J, Manka L, Yassin A et al. Effect of testosterone treatment in hypogonadal men on prostate cancer risk: results of a prospective comparative study – 8 years follow-up analysis to age-matched controls. ASCO Meeting Abstracts 2014.
15. Agarwal PK, Oefelein MG. Testerone replacement therapy after primary treatment for prostate cancer. J Urol 2005; 173: 533–6.
16. Khera M, Grober ED, Najari B et al. Testosterone replacement therapy following radical prostatectomy. J Sex Med 2009; 6: 1165–70.
17. Pastuszak AW, Pearlman AM, Lai WS et al. Testosterone replacement therapy in patients with prostate cancer after radical prostatectomy. J Urol 2013; 190: 639–44.
18. Bellefqih S, Hadadi K, Mezouri I et al. Combined radiation therapy and androgen deprivation in the management of prostate cancer: Where do we stand? Cancer Radiother 2016; 8.
19. Pastuszak AW, Pearlman AM, Godoy G et al. Testosterone replacement therapy in the setting of prostate cancer treated with radiation. Int J Impot Res 2013; 25: 24–8.
20. Song W, Khera M. Physiological normal levels of androgen inhibit proliferation of prostate cancer cells in vitro. Asian J Androl 2014; 16: 864.
21. American Cancer Society recommendations for prostate cancer early detection. Available at: https: //www.cancer.org/cancer/prostate-cancer/early-detection/acs-recommendations.html
22. Khera M, Crawford D, Morales A et al. A new era of testosterone and prostate cancer: from physiology to clinical implications. Eur Urol 2014; 65: 115–23.
23. Kühn CM, Strasser H, Romming A et al. Testosterone Replacement Therapy in Hypogonadal Men Following Prostate Cancer Treatment: A Questionnaire-Based Retrospective Study among Urologists in Bavaria, Germany. Urol Int 2015; 95: 153–9.
24. Sarosdy MF. Testosterone replacement for hypogonadism after treatment of early prostate cancer with brachytherapy. Cancer 2007; 109: 536–41.
25. Balbontin FG, Moreno SA, Bley E et al. Long-acting testosterone injections for treatment of testosterone deficiency after brachytherapy for prostate cancer. BJU Int 2014; 114: 125–30.
26. Pastuszak AW, Khanna A, Badhiwala N et al. Testosterone therapy after radiation therapy for low, intermediate, and high risk prostate cancer. J Urol 2015; 194: 1271–6.
27. Kaplan AL, Trinh QD, Sun M et al. Testosterone replacement therapy following the diagnosis of prostate cancer: outcomes and utilization trends. J Sex Med 2014; 11: 1063–70.
28. Kaplan AL, Lenis AT, Shah A et al. Testosterone replacement therapy in men with prostate cancer: a time-varying analysis. J Sex Med 2015; 12: 374–80.
29. Morgentaler A, Rhoden EL. Prevalence of prostate cancer among hypogonadal men with prostate-specific antigen levels of 4.0 ng/ml or less. Urology 2006; 68: 1263–7.
30. Kacker R, Mariam H, San Francisco IF et al. Can testosterone therapy be offered to men on active surveillance for prostate cancer? Preliminary results. Asian J Androl 2016; 18 (1): 16–20.

________________________________________________

1. Morgentaler A. Testosterone and prostate cancer: an historical perspective on a modern myth. Eur Urol 2006; 50 (5): 935.
2. Fernández-Miró M, Chillarón JJ, Pedro-Botet J. Testosterone deficiency, metabolic syndrome and diabetes mellitus. Med Clin 2016; 146 (2): 69–73.
3. Lytton B. Prostate cancer: a brief history and the discovery of hormonal ablation treatment. J Urol 2001; 3: 37–8.
4. Surampudi PN, Wang C, Swerdloff R. Hypogonadism in the aging male diagnosis, potentials benefits, and risks of testosterone re- placement therapy. Int J Endocrinol 2012; 2 (2): 23–34.
5. SEER Cancer Statistics Factsheets: Prostate Cancer. National Cancer Institute; Bethesda, MD, USA. Available at: http://seer.cancer.gov/statfacts/html/prost.html
6. Zhou Y, Bolton EC, Jones JO. Androgens and androgen receptor signaling in prostate tumorigenesis. J Mol Endocrinol 2015; 54 (1): 15–29.
7. Huggins C, Hodges CV. The effect of castration, of estrogen and of androgen injection on serum phosphatase on metastatic carcinoma of the prostate. Cancer Res 1941; 1: 293–7.
8. Brooke GN, Bevan CL. The role of androgen receptor mutations in prostate cancer progression. Curr Genomics 2009; 10 (1): 18–25.
9. Prehn RT. On the prevention and therapy of prostate cancer by androgen administration. Cancer Res 1999; 59: 4161–4.
10. DeVore NM, Scott EE. Structures of cytochrome P450 17A1 with prostate cancer drugs abiraterone and TOK-001. Nature 2012; 22: 116.
11. Zhou Y, Otto-Duessel M, He M et al. Low systemic testosterone levels induce androgen maintenance in benign rat prostate tissue. J Mol Endocrinol 2013; 51: 143–53.
12. Traish AM, Miner MM, Morgentaler A et al. Testosterone deficiency. Am J Med 2011; 124 (7): 578–87.
13. Stattin P, Lumme S, Tenkanen L et al. High levels of circulating testosterone are not associated with increased prostate cancer risk: a pooled prospective study. Int J Can 2004; 108: 418–24.
14. Yassin D-J, Manka L, Yassin A et al. Effect of testosterone treatment in hypogonadal men on prostate cancer risk: results of a prospective comparative study – 8 years follow-up analysis to age-matched controls. ASCO Meeting Abstracts 2014.
15. Agarwal PK, Oefelein MG. Testerone replacement therapy after primary treatment for prostate cancer. J Urol 2005; 173: 533–6.
16. Khera M, Grober ED, Najari B et al. Testosterone replacement therapy following radical prostatectomy. J Sex Med 2009; 6: 1165–70.
17. Pastuszak AW, Pearlman AM, Lai WS et al. Testosterone replacement therapy in patients with prostate cancer after radical prostatectomy. J Urol 2013; 190: 639–44.
18. Bellefqih S, Hadadi K, Mezouri I et al. Combined radiation therapy and androgen deprivation in the management of prostate cancer: Where do we stand? Cancer Radiother 2016; 8.
19. Pastuszak AW, Pearlman AM, Godoy G et al. Testosterone replacement therapy in the setting of prostate cancer treated with radiation. Int J Impot Res 2013; 25: 24–8.
20. Song W, Khera M. Physiological normal levels of androgen inhibit proliferation of prostate cancer cells in vitro. Asian J Androl 2014; 16: 864.
21. American Cancer Society recommendations for prostate cancer early detection. Available at: https: //www.cancer.org/cancer/prostate-cancer/early-detection/acs-recommendations.html
22. Khera M, Crawford D, Morales A et al. A new era of testosterone and prostate cancer: from physiology to clinical implications. Eur Urol 2014; 65: 115–23.
23. Kühn CM, Strasser H, Romming A et al. Testosterone Replacement Therapy in Hypogonadal Men Following Prostate Cancer Treatment: A Questionnaire-Based Retrospective Study among Urologists in Bavaria, Germany. Urol Int 2015; 95: 153–9.
24. Sarosdy MF. Testosterone replacement for hypogonadism after treatment of early prostate cancer with brachytherapy. Cancer 2007; 109: 536–41.
25. Balbontin FG, Moreno SA, Bley E et al. Long-acting testosterone injections for treatment of testosterone deficiency after brachytherapy for prostate cancer. BJU Int 2014; 114: 125–30.
26. Pastuszak AW, Khanna A, Badhiwala N et al. Testosterone therapy after radiation therapy for low, intermediate, and high risk prostate cancer. J Urol 2015; 194: 1271–6.
27. Kaplan AL, Trinh QD, Sun M et al. Testosterone replacement therapy following the diagnosis of prostate cancer: outcomes and utilization trends. J Sex Med 2014; 11: 1063–70.
28. Kaplan AL, Lenis AT, Shah A et al. Testosterone replacement therapy in men with prostate cancer: a time-varying analysis. J Sex Med 2015; 12: 374–80.
29. Morgentaler A, Rhoden EL. Prevalence of prostate cancer among hypogonadal men with prostate-specific antigen levels of 4.0 ng/ml or less. Urology 2006; 68: 1263–7.
30. Kacker R, Mariam H, San Francisco IF et al. Can testosterone therapy be offered to men on active surveillance for prostate cancer? Preliminary results. Asian J Androl 2016; 18 (1): 16–20.

Авторы

С.О.Сухих*, А.О.Васильев, А.В.Говоров, Д.Ю.Пушкарь

ФГБОУ ВО «Московский государственный медико-стоматологический университет им. А.И.Евдокимова» Минздрава России. 127473, Россия, Москва, ул. Делегатская, д. 20, стр. 1
*docsukhikh@gmail.com

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S.O.Sukhikh*, A.O.Vasilyev, A.V.Govorov, D.Yu.Pushkar

A.I.Evdokimov Moscow State University of Medicine and Dentistry of the Ministry of Health of the Russian Federation. 127473, Russian Federation, Moscow, ul. Delegatskaia, d. 20, str. 1
*docsukhikh@gmail.com

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