Testosterone replacement therapy (TRT) is the administration of testosterone to men with abnormally low testosterone, termed hypogonadism, or "low T," Men with symptoms of low testosterone, can often benefit from TRT. Common symptoms of hypogonadism in post-pubertal men commonly include decreased muscle mass, decreased energy, depressed mood, decreased libido, decreased spontaneous erections, and erectile dysfunction [Wang et al., 2008, Basaria, 2014].
While TRT has been used for decades the last decade has seen a dramatic increase in the use of TRT. The percentage of men in the Unites States over 40 years of age prescribed TRT increased from less than 1% in 2001 to nearly 3% in 2011 [Baillargeon et al., 2013]. The increase in TRT and lack of data from large, long term randomized controlled trials (RCT) has raised concern for unrecognized adverse health risks, including potential increases in cardiovascular disease and prostate cancer (PC).
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| Changes in androgen use over time. From Baillargeon et al., 2013. |
There is large body of both historic and modern data supporting a role for androgens in PC pathogenesis and progression.
In 1941, Huggins and Hodges proposed that PC growth was driven by androgens, after observing benefits of castration in PC patients [Huggins et al., 1941]. Current laboratory data demonstrate that many PC cell lines depend on testosterone for growth and spread. [Kyprianou et al., 1990, Webber et al., 1996, Schwab et al., 2000]. In animal models, testosterone promotes PC tumor growth [Bladou et al., 1996, Ahmad et al., 2008].The data supporting the androgen hypothesis has led to the dogma that TRT in PC patients is like "feeding the fire." Historically, there is data supporting this concept. In 1982 Fowler et al. reported on 52 men with metastatic PC patients who recieved testosterone. 38% of men had elevations in prostatic acid phosphatase (a blood test used to monitor PC), 2 men had measurable metastatic progression, and ther were 4 deaths [Fowler et al., 1982]. Importantly, these patients had advanced disease, and many had prior androgen deprivation [Fowler et al., 1982]. Thus, it would not be appropriate to apply these observations to men with clinically localized disease who receive early primary treatment and PSA monitoring.
There is currently no reliable data indicating an increase in PC in men without PC undergoing TRT.
The majority of studies on TRT and PC are small, and to date, there have been no prospective studies on TRT with sufficient patient numbers to determine increased PC risk. By one estimate, 6,000 patients receiving 5 years of TRT would be needed to detect a 30% increase in PC incidence [Bhasin et al., 2003]. In a systematic review of 40 prospective studies, there was no study which demonstrated an association between TRT and PC risk in men without prior PC. In addition, a meta-analysis of 19 studies, there was no significant increase in PC or significant PSA increases necessitating prostate biopsy. [Calof et al., 2005].TRT in patients with localized PC appears safe, based on limited data
Using Medicare data, Kaplan and colleagues reported on 149,354 men, including 1,181 men who received TRT after a diagnosis with PC. Overall, TRT was not associated with PC deaths [Kaplan et al., 2014]. Similarly, Pastuszak and colleagues reported on 103 men who after prostatectomy were treated with TRT. There was an overall increase serum PSA, but no evidence of increased cancer recurrence over 36 months [Pastuszak et al., 2013]. In a smaller study, Morgentaler et al. examined 13 patients with untreated PC, enrolled in an active surveillence program and receiving TRT. After a median follow-up of 2.5 years, 2 men had worse pathology on subsequent biopsy, but no cases of disease or PSA progression were seen [Morgentaler et al., 2011].Summary
Overall, there remains no clear answer to the question "Does testosterone promote prostate cancer development in humans?" Thus, TRT in men with prostate cancer remains controversial. There is clear evidence that androgens can promote PC in animal models. It is clear that the influence of testosterone on PC disease progression is of paramount importance to both patients and providers as they weight the potential benefits of TRT. Currently, there is a growing amount of evidence that TRT is safe in well-selected men with clinically localized PC. However, these results are based on TRT in a small number of patients. Furthermore, the heterogeneity in PC progression and aggressiveness may give rise to heterogeneity in the responsiveness of tumors to TRT. Thus, until the results of future RCTs are available, TRT should only be offered to select patients who are carefully monitored and well-informed about the potential risks and benefits.
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I glorify the lord Almighty on your behalf sir Dr Chukwu Madu herbal home, let the grace continue with you. Am so happy right now am cured totally from Cancer with the help of your herb DR Chukwu Madu herbal home.
ReplyDeleteYou have been curing people with your powerful herbs thank you so much for your truth and straight forwardness towards your patients ,I read about your great herbal home on the Internet and how you cure people of their different virus and I contacted you without time wasting when you told me I will be totally cured soon and I hoped on you ,and you never let me down. My name DESMOND WALTER from Texas. Am greatfull Doc. Viewers join me say thank you to this great herbalist from Nigeria part of African who cures people of their Virus with his great herbs, even if you have some days to live contact him and be saved forever iam very sure of Dr Chukwu Madu herbal home.[ dr.chukwumaduherbalhome@gmail.com] or talk with him directly on WhatsApp via [+2347030936239] am all good DOC.
I glorify the lord Almighty on your behalf sir Dr Chukwu Madu herbal home, let the grace continue with you. Am so happy right now am cured totally from Cancer with the help of your herb DR Chukwu Madu herbal home.
ReplyDeleteYou have been curing people with your powerful herbs thank you so much for your truth and straight forwardness towards your patients ,I read about your great herbal home on the Internet and how you cure people of their different virus and I contacted you without time wasting when you told me I will be totally cured soon and I hoped on you ,and you never let me down. My name DESMOND WALTER from Texas. Am greatfull Doc. Viewers join me say thank you to this great herbalist from Nigeria part of African who cures people of their Virus with his great herbs, even if you have some days to live contact him and be saved forever iam very sure of Dr Chukwu Madu herbal home.[ dr.chukwumaduherbalhome@gmail.com] or talk with him directly on WhatsApp via [+2347030936239] am all good DOC.
Suffering from herpes virus is a terrible experience because i was told it has no cure,the good news am happily sharing now is the great power behind herbal medication i got diagnosed of herpes virus in the year 2016 and in 2018 i started having outbreaks and it became more terrible for me to bare,One blissful morning i came across a blog comment posted by a man call Thompson on how he was cured of herpes simplex virus type 2 with the herbal medication of Dr CHUKWU MADU Herbal Home) who is a specialist in curing all kinds of std virus and chronic disease with herbs,i immediately copied out his contact mail that was dr.chukwumaduherbalhome@gmail.com Or Via WhatsApp +2347030936239 and i explain all my problems to him, he was very honest with me and also kept his promise to get me cured with his herbs if i follow the prescriptions he gives along with the medication which i did exactly as he prescribed, to God be the glory My herpes simplex virus i have been suffering from got cured in just 2 weeks after completing the dose of his herbal cure. once again thank you so much sir for restoring my health back and most especially my skin. Please for any who has health problem of any kind should mail him on the email provided above. Give him a chance and see what he can do. JANE lisaru from MALAYSIA.
ReplyDelete.
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ReplyDeletei want to inform the public how i was cured of HERPES Simplex Virus by a Doctor called Dr.EBHOTA. i visited different hospital but they gave me list of drugs like Famvir, Zovirax, and Valtrex which is very expensive to treat the symptoms and never cured me. I was browsing through the Internet searching for remedy on HERPES and i saw comment of people talking about how Doctor EBHOTA cured them. I Was scared because i never believed in the Internet but i was convince to give him a try because i was having no hope of been cured of HERPES so i decided to contact him on his email, i searched his email on net and i saw a lot of people testifying about his goodness. when i contacted him he gave me hope and send a Herbal medicine to me that i took and it seriously worked for me, am a free person now without problem, my HERPES result came out negative. You can contact him on
ReplyDeletehis Email: drebhotasolution@gmail.com or whatsapp him on +2348089535482 and get all your problem solved.
1Sickness of any kind
2 Help to CURE Hepatitis B, HIV/AIDs CANCER and BIPOLAR
3 Divorce, Breakup problem and To Re-unit
4 Pregnancy problem
5 Financial problem and Job promotion
6 To get a good and rich life partner
7 To Lose your wath
8 to enlargement of pennis
9. CANCER
10. ALS (Lou Gehrig's disease)
11 Hepatitis B
12 chronic pancreatic
13 emphysema
14 COPD (chronic obstructive pulmonary disease)
WHAT A GREAT MIRACLE THAT I HAVE EVER SEE IN MY LIFE. My names are Clara David I’m a citizen of USA, My younger sister was sicking of
ReplyDeletebreast cancer and her name is Sandra David I and my family have taking her
to all kind of hospital in USA still yet no good result. I decided to go to
the internet and search for cancer cure so that was how I find a lady
called peter Lizzy she was testifies to the world about the goodness of a
herbal man who has the roots and herbs to cure all kind of disease and the
herbal man email was there. So I decided to contact the herbal man @herbalist_sakura for my younger sister help to cure her breast cancer. I contacted him and told him
my problem he told me that I should not worry that my sister cancer will be
cure, he told me that there is a medicine that he is going to give me that
I will cook it and give it to my sister to drink for one week, so I ask how
can I receive the cure that I am in USA, he told me
That I will pay for the delivery service. The courier service can
transport it to me so he told me the amount I will pay, so my dad paid for
the delivery fee. two days later I receive the cure from the courier
service so I used it as the herbal man instructed me to, before the week
complete my sister cancer was healed and it was like a dream to me not
knowing that it was physical I and my family were very happy about the
miracle of Doctor so my dad wanted to pay him 5 million us dollars the
herbal man did not accept the offer from my dad, but I don't know why he
didn't accept the offer, he only say that I should tell the world about him
and his miracle he perform so am now here to tell the world about him if
you or your relative is having any kind of disease that you can't get from
the hospital please contact dr.sakuraspellalter@gmail.com or whats app him
+2348110114739 you can follow him up on Instagram @herbalist_sakura for the cure, he will help you out with the
problem. And if you need more information about the doctor you can mail me
davidclara223@gmail.com
WHAT A GREAT MIRACLE THAT I HAVE EVER SEE IN MY LIFE. My names are Clara David I’m a citizen of USA, My younger sister was sicking of
ReplyDeletebreast cancer and her name is Sandra David I and my family have taking her
to all kind of hospital in USA still yet no good result. I decided to go to
the internet and search for cancer cure so that was how I find a lady
called peter Lizzy she was testifies to the world about the goodness of a
herbal man who has the roots and herbs to cure all kind of disease and the
herbal man email was there. So I decided to contact the herbal man @herbalist_sakura for my younger sister help to cure her breast cancer. I contacted him and told him
my problem he told me that I should not worry that my sister cancer will be
cure, he told me that there is a medicine that he is going to give me that
I will cook it and give it to my sister to drink for one week, so I ask how
can I receive the cure that I am in USA, he told me
That I will pay for the delivery service. The courier service can
transport it to me so he told me the amount I will pay, so my dad paid for
the delivery fee. two days later I receive the cure from the courier
service so I used it as the herbal man instructed me to, before the week
complete my sister cancer was healed and it was like a dream to me not
knowing that it was physical I and my family were very happy about the
miracle of Doctor so my dad wanted to pay him 5 million us dollars the
herbal man did not accept the offer from my dad, but I don't know why he
didn't accept the offer, he only say that I should tell the world about him
and his miracle he perform so am now here to tell the world about him if
you or your relative is having any kind of disease that you can't get from
the hospital please contact dr.sakuraspellalter@gmail.com or whats app him
+2348110114739 you can follow him up on Instagram @herbalist_sakura for the cure, he will help you out with the
problem. And if you need more information about the doctor you can mail me
davidclara223@gmail.com
FINALLY FREE FROM CANCER DISEASE.
ReplyDeletewhat a miracle i never believe there is cure because my doctor tested me cancer positive and she told me there is no cure, i’m very happy today that i’m having a free life without this CANCER virus, i can remember some months ago when i was crying all through the night and day that i can’t get cured from this CANCER, i found this herbal man called Dr adazal on internet when i was doing research on cure for shingle i contacted him to found out if i can get help from this cancer virus, i was so surprise when he told me that he have the herbs cure to it and he sent me the herbal in less down 5 days i was so happy when i get someone giving me hope that he can cured me i took the herbal for just 2 weeks, when i went for test after taking the herbal i found out that i am cured i was so happy and surprise, i want to use this opportunity to inform you that there is cured to cancer virus you can also contact him for his help as soon as possible so that you can get rid of this cancer once and for all you can reach him through this email: dr,adazalherbalcure@gmail.com or whatsApp him on +2348073688335 You can also contact him on any disease and virus in this he all have the herbal cure to it.
1 HIV/AIDS
2 HERPES
3 CANCER
4 ALS
5 HEPATITIS
6 DIABETES
7 LOVE SPELL
8 INFECTIONS
9 HIGN BLOOD PRESSURE,.....
THANKS TO DR adazal FOE THE GOOD WORK IN LIFE YOU ARE TRULY A BLESS.
FINALLY FREE FROM HERPES VIRUS
ReplyDeleteI thought my life had nothing to offer anymore because lifebecame meaningless to me because I had Herpes virus, thesymptoms became very severe and bold and made my familyrun from and abandoned me so they won't get infected. I gaveup everything, my hope, dreams,vision and job because thedoctor told me there's no cure. I consumed so many drugs butthey never cured me but hid the symptoms inside me makingit worse. I was doing some research online someday when Icame across testimonies of some people of how DR Ebhotacured them from Herpes, I never believed at first and thoughtit was a joke but later decided to contact him on the detailsprovided and when I messaged him we talked and he sent mehis herbal medicine and told me to go for a test after twoweeks. Within 7 days of medication the symptomsdisappeared and when I went for a test Lo and behold I wasNEGATIVE by the Doctor Who tested me earlier. Thank you DREbhota because I forever owe you my life and I'll keep ontelling the world about you. If you are going through samesituation worry no more and contact DR Ebhota viadrebhotasolution@gmail. com or WhatsApp him via +2348089535482.he also special on cureing 1. HIV/AIDS2. HERPES 3. CANCER 4.ALS 5. HEPATITIS B 6.DIABETES 7. HUMAN PAPILOMA VIRUS DISEASE(HPV)8. ALZHEIMER 9. LUPUS (Lupus Vulgaris or LupusErythematosus
herbs that increase testosterone is the safe and natural way to support healthy testosterone levels for men
ReplyDeleteI want to share this wonderful testimony to the Good people all over the world on how I was able to Enlarge my Penis by Dr. Aziba. I was living a shameful life from my young age, just last month as I was browsing on the internet about Penis size and Enlargement Products, I saw a testimony of a Man called Tim James testifying of how he was able to get his penis Enlarged by Dr. Aziba and I decided to also Email Dr. Aziba for my small penis size and he quickly respond to me and gave me the normal instructions which i did and then he shipped the product to me here in the united state which i received in just 3 working days and today i am very happy because i started seeing positive changes in my penis size in just 7 days of use. Dr Aziba herbal product is the best recommended for you and to whom ever suffering from this shame or having any other diseases as well should Contact this great herbal doctor via his Email : Priestazibasolutioncenter@gmail.com and WhatsApp Him on +2348100368288
ReplyDeleteI want to share this wonderful testimony to the Good people all over the world on how I was able to Enlarge my Penis by Dr. Aziba. I was living a shameful life from my young age, just last month as I was browsing on the internet about Penis size and Enlargement Products, I saw a testimony of a Man called Tim James testifying of how he was able to get his penis Enlarged by Dr. Aziba and I decided to also Email Dr. Aziba for my small penis size and he quickly respond to me and gave me the normal instructions which i did and then he shipped the product to me here in the united state which i received in just 3 working days and today i am very happy because i started seeing positive changes in my penis size in just 7 days of use. Dr Aziba herbal product is the best recommended for you and to whom ever suffering from this shame or having any other diseases as well should Contact this great herbal doctor via his Email : Priestazibasolutioncenter@gmail.com and WhatsApp Him on +2348100368288
ReplyDeleteHerbal medicine is 100% guaranteed to cure Penis Enlargement and long lasting The main reason why lots of people are finding it difficult to Enlarge penis and last long during xxx is because they so believe in medical report and drugs made of chemicals which cause damages to the body system. so I'm recommending fellow m to contact Dr Aziba WhatsApp via +2348100368288 or Email : priestazibasolutioncenter@gmail.com for Natural Herbal Penis Enlargement Product
ReplyDeleteHerbal medicine is 100% guaranteed to cure Penis Enlargement and long lasting The main reason why lots of people are finding it difficult to Enlarge penis and last long during xxx is because they so believe in medical report and drugs made of chemicals which cause damages to the body system. so I'm recommending fellow m to contact Dr Aziba WhatsApp via +2348100368288 or Email : priestazibasolutioncenter@gmail.com for Natural Herbal Penis Enlargement Product
Herbal medicine is 100% guaranteed to cure Penis Enlargement and long lasting The main reason why lots of people are finding it difficult to Enlarge penis and last long during xxx is because they so believe in medical report and drugs made of chemicals which cause damages to the body system. so I'm recommending fellow m to contact Dr Aziba WhatsApp via +2348100368288 or Email : priestazibasolutioncenter@gmail.com for Natural Herbal Penis Enlargement Product
I'm very excited to inform everyone that I'm completely cured from my HSV 1&2 recently. I have used Oregano oil, Coconut oil, Acyclovir, Val acyclovir, Famciclovir , and some other products and it's really help during my outbreaks but I totally got cured from my HSV 2 with a strong and active herbal medicine ordered from a powerful herbalist and it completely fought the virus from my nervous system and I was tested negative after three weeks of usage. I'm here to let y'all know that HSV 1& 2 has a complete cure, I got rid of mine with the help of Dr Moses Buba and his herbal exploit, AFTER I engage with other wrong doctors. Contact him via email: buba.herbalmiraclemedicine@gmail.com or Call/WhatsApp him at +2349060529305
ReplyDeletethank you..
I'm very excited to inform everyone that I'm completely cured from my HSV 1&2 recently. I have used Oregano oil, Coconut oil, Acyclovir, Val acyclovir, Famciclovir , and some other products and it's really help during my outbreaks but I totally got cured from my HSV 2 with a strong and active herbal medicine ordered from a powerful herbalist and it completely fought the virus from my nervous system and I was tested negative after three weeks of usage. I'm here to let y'all know that HSV 1& 2 has a complete cure, I got rid of mine with the help of Dr Moses Buba and his herbal exploit, AFTER I engage with other wrong doctors. Contact him via email: buba.herbalmiraclemedicine@gmail.com or Call/WhatsApp him at +2349060529305
ReplyDeletethank you..
I was diagnosed as HEPATITIS B carrier in 2013 with fibrosis of the
ReplyDeleteliver already present. I started on antiviral medications which
reduced the viral load initially. After a couple of years the virus
became resistant. I started on HEPATITIS B Herbal treatment from
ULTIMATE LIFE CLINIC (www.ultimatelifeclinic.com) in March, 2020. Their
treatment totally reversed the virus. I did another blood test after
the 6 months long treatment and tested negative to the virus. Amazing
treatment! This treatment is a breakthrough for all HBV carriers.