It’s been known for a while that hormone levels drop in women treated for cancer. Now a study published in the Journal of Clinical Oncology is showing similar effects in older men. MSNBC Health reports:
For the new study, researchers tested more than 400 men with cancers that were unrelated to testosterone.
Nearly half the men had total testosterone levels below 300 nanograms per deciliter. The researchers didn’t compare the men to a control group, but note that all other studies of men without cancer have found some percentage with lowered testosterone levels, but far less than half.
The men in the current study with low testosterone also tended to be overweight or obese, and scored slightly lower on a scale designed to measure quality of life than men with “normal” testosterone levels.
However, there are some important caveats:
- The study was sponsored by Solvay Pharmaceuticals, which manufactures a testosterone cream. Since the study was essentially designed to identify a target market for their product, that makes the results somewhat suspect. I would like to see the results replicated by another study that’s independently funded–and that includes a control group, which this study didn’t have.
- Any study examining testosterone levels will be hampered by “a lack of consensus on what constitute a normal range of testosterone levels, the well-known inaccuracy of measuring serum bioavailable testosterone levels, and the considerable interindividual variation in the degree of testosterone decline associated with age,” according to this 2006 article in the International Journal of Impotence Research.
- According to that same article, it isn’t even clear whether testosterone affects prostate cancer, and if there is a connection, it’s that too much testosterone increases the risk of cancer. So when the researchers say that next they’re going to see whether testosterone supplementation increases the prognosis for these cancer patients, they’re pretty much talking nonsense.
If you’re a man who’s had cancer, and you’re having problems such as impotence that could be related to low testosterone levels, do consult your oncologist and maybe an endocrinologist or urologist–but don’t panic.
Here’s some exciting (if preliminary) news from a big study conducted by the University of Texas Southwestern Medical School, reported by Reuters:
Prostate cancer patients who had been treated with either surgery or radiation, and who took aspirin or other anticoagulant drugs such as warfarin, were far less likely to die of cancer, the researchers said.
Those who took the drugs had a 4 percent risk of dying from prostate cancer after 10 years, compared to 10 percent for men who did not take anticoagulants.
Men with high-risk prostate cancer benefited the most, the researchers said ahead of an American Society for Radiation Oncology meeting, which starts next week in San Diego.
…
Choe’s team looked at a study of 5,275 men whose cancer had not spread beyond the prostate gland. Of the men, 1,982 were taking anticoagulants.
Those taking aspirin or other drugs to reduce clotting were far less likely to have the prostate tumors pop up elsewhere in their bodies and were less likely to die, Choe’s team said in materials published ahead of the meeting.
It’s important to note that these patients were already taking anticoagulants* on a regular basis. So it could just be the case that men who are prone to deep vein thrombosis, heart attacks, and other problems commonly treated or prevented with anticoagulants are also prone to living longer after having prostate cancer. Other studies will be needed to determine whether aspirin really makes a difference in cancer prognosis when men take it who have no other reason to take an anticoagulant.
On the other hand, look at those numbers: Nearly 38% of the patients were taking anticoagulants. Prostate cancer affects billions of men worldwide, and 38% of billions is a lot of people. So at the very least, anyone who gets prostate cancer can be relatively assured that their anticoagulants are not going to make the cancer worse, and that will be a big relief. It’s certainly a much better outcome than having to choose between treating cancer and preventing heart attacks.
* An anticoagulant is a medication used to prevent blood clotting. Commonly 
known as blood thinners, anticoagulants are used in a variety of medical scenarios, such as deep vein thrombosis (DVT). Some people with cancer are at a higher risk of developing DVT because of the type of cancer they have or type of chemotherapy they are undergoing.
Common types of anticoagulants include Heparin* and Warfarin*. These anticoagulants can prevent the extension of existing clots and prevent new ones from forming.
*HEPARIN is an anticoagulant. It is used to treat or prevent clots in the veins, arteries, lungs, or heart. It stops clots from forming or getting bigger. This medicine prevents clotting during open-heart surgery, dialysis, or in patients who are confined to bed.
This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.
Your health care provider needs to know if you have any of these conditions:
•bleeding disorders, such as hemophilia or low blood platelets
•bowel disease or diverticulitis
•endocarditis
•high blood pressure
•liver disease
•recent surgery or delivery of a baby
•stomach ulcers
•an unusual or allergic reaction to heparin, benzyl alcohol, sulfites, other medicines, foods, dyes, or preservatives
•pregnant or trying to get pregnant
•breast-feeding
Side effects that you should report to your doctor or health care professional as soon as possible:
•allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue
•any sign of bleeding like bruising, pinpoint red spots on the skin, black, tarry stools, blood in the urine, bleeding gums, nosebleeds
•back pain
•bleeding in the eye
•breathing problems
•burning or itching on the bottoms of the feet
•cold, blue, or painful hands and feet
•coughing up blood
•feeling faint or lightheaded, falls
•fever, chills
•heavy menstrual bleeding
•nausea, vomiting
•stomach pain
•unusually low blood pressure
Side effects:
that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):
•pain at site where injected
This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
While you are taking this medicine, carry an identification card with your name, the name and dose of medicine(s) being used, and the name and phone number of your doctor or health care professional or person to contact in an emergency.
Notify your doctor or health care professional at once if you have cold, blue hands or feet, or any unusual bleeding. Monitor your skin closely for easy bruising or red spots, which can indicate bleeding.
If you are going to have surgery or dental work, tell your doctor or health care professional that you have received this medicine. Be careful brushing and flossing your teeth or using a toothpick while receiving this medicine because you may bleed more easily.
Avoid sports and activities that might cause injury while you are using this medicine. Severe falls or injuries can cause unseen bleeding. Be careful when using sharp tools or knives. Consider using an electric razor.
*WARFARIN is an anticoagulant. It is used to treat or prevent clots in the veins, arteries, lungs, or heart.
This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.
Your health care provider needs to know if you have any of these conditions:
•alcoholism
•anemia
•blood disease, bleeding disorders, hemorrhage, hemophilia or aneurysm
•bowel disease, diverticulitis, or ulcers
•cancer
•diabetes
•heart disease
•heart valve infection
•high blood pressure
•history of bleeding in the gastrointestinal tract
•history of stroke or other brain injury or disease
•kidney or liver disease
•older than 65 years
•protein or vitamin deficiency
•psychosis or dementia
•recent surgery or injury
•an unusual or allergic reaction to warfarin, other medicines, foods, dyes, or preservatives
•pregnant or trying to get pregnant
•breast-feeding
Side effects that you should report to your doctor or health care professional as soon as possible:
back or stomach pain
chest pain or fast or irregular heartbeat
difficulty breathing or talking, wheezing
dizziness
fever or chills
headaches
heavy menstrual bleeding or vaginal bleeding
nausea, vomiting
painful, blue, or purple toes
painful, prolonged erection
prolonged bleeding from cuts
signs and symptoms of bleeding such as bloody or black, tarry stools, red or dark-brown urine, spitting up blood or brown material that looks like coffee grounds, red spots on the skin, unusual bruising or bleeding from the eye, gums, or nose
skin rash, itching or skin damage
unusual swelling or sudden weight gain
unusually weak or tired
yellowing of skin or eyes
Side effects:
that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):
diarrhea
unusual hair loss
This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Visit your doctor or health care professional for regular checks on your progress. You will need to have your blood checked regularly to make sure you are getting the right dose of this medicine. When you first start taking this medicine, these tests are done often. Once the correct dose is determined and you take your medicine properly, these tests can be done less often.
While you are taking this medicine, carry an identification card with your name, the name and dose of medicine(s) being used, and the name and phone number of your doctor or health care professional or person to contact in an emergency.
You should discuss your diet with your doctor or health care professional. Many foods contain high amounts of vitamin K, which can interfere with the effect of this medicine. Your doctor or health care professional may want you to limit your intake of foods that contain vitamin K. Foods that have moderate to high amounts of vitamin K include brussel sprouts, kale, green tea, asparagus, avocado, broccoli, cabbage, cauliflower, collard greens, liver, soybean oil, soybeans, certain beans, mustard greens, peas (black eyed peas, split peas, chick peas), turnip greens, parsley, green onions, spinach, and lettuce.
This medicine can cause birth defects or bleeding in an unborn child. Women of childbearing age should use effective birth control while taking this medicine. If a woman becomes pregnant while taking this medicine, she should discuss the potential risks and her options with her health care professional.
Avoid sports and activities that might cause injury while you are using this medicine. Severe falls or injuries can cause unseen bleeding. Be careful when using sharp tools or knives. Consider using an electric razor. Take special care brushing or flossing your teeth. Report any injuries, bruising, or red spots on the skin to your doctor or health care professional.
If you have an illness that causes vomiting, diarrhea, or fever for more than a few days, contact your doctor. Also check with your doctor if you are unable to eat for several days. These problems can change the effect of this medicine.
Even after you stop taking this medicine, it takes several days before your body recovers its normal ability to clot blood. Ask your doctor or health care professional how long you need to be careful. If you are going to have surgery or dental work, tell your doctor or health care professional that you have been taking this medicine.
Question: How can I tell if I have a DVT ?
Answer: It can be hard to recognize a DVT; many of the symptoms resemble other conditions. If you think you may have a DVT, call your doctor immediately. If you think you’re having a PE, Call 911.
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