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On the question of development and promising methods of treating prostate cancer
After transformation from androgen-independent transitory proliferate cells, the androgen-dependent pool of transitional cells (Lopatkin N.A., 1998) requires the presence of a physiologically necessary level of testosterone for further development. A decrease in the testosterone level is compensated both by an increase in aromatase and 5α- reductase activity, and by an additional increase in production by cells of peptide growth factors: bFGF and others (Pechersky A.V. et al., 2003). Natural immunity reactions are initiated by a series of chemical structures (glycoproteins, containing mannose, and others), that appear among old, proliferate, and malignant cells (A.A. Yarilin, 1999). Highly-active forms of oxygen and nitrogen, as well as other factors, determine the cytolytic (including anti-neoplastic) action of monocytes, macrophages, neutrophils and cytotoxic T-cells to a significant degree (Yarilin A.A., 1999; Roitt I. et al., 2000). The use of antioxidants consistently decreases the effectiveness of the immune system response under an increase in mitotic activity of cells. Therefore the anti-proliferative effect of a series of phyto-preparations, described by many authors, is apparently caused not by their antioxidant activity, but rather by different reasons. When using a series of phyto-preparations (Gentos), one can observe a decrease in the levels of luteinizing hormone, 5α-dihydrotestosterone and estradiol, the increase of which is observed during a decrease in testosterone production (A.V. Pechersky, et al., 2000). From this position, the use of a series of phyto-preparations among patients with PADAM can be viewed as an analogue to androgen replacement therapy, and several of the components can be viewed as phyto-androgens (having a similar effect) (Pechersky A.V., et al., 2000). At the same time, phyto-preparations can’t replace the missing testosterone completely. When there is an obvious need to conduct androgen-replacement therapy, the dose of the preparation shouldn’t exceed the quantity of the hormone that decreases with age. The danger of prescribing surplus doses of testosterone preparations was shown in research done in the last century on mechanisms of development of prostate cancer. As a hypothesis, one can suppose that prescribing small doses of testosterone (suiting the age-related decrease in hormone production) between courses of conducting an androgen blockade will help improve the results of treatment of patients with prostate cancer. It’s possible that this therapy will be effective for active surveillance of the abovementioned patients.
Alexander V. Pechersky, MD, PhD as part of Beyond the Abstract on UroToday.com. This initiative offers a method of publishing for the professional urology community. Authors are given an opportunity to expand on the circumstances, limitations etc... of their research by referencing the published abstract.
Senior Lecturer, Department of Urology, North-Western State Medical University named after I.I. Mechnikov, 41, Kirochnaya St., St. Petersburg, 193015, Russia