Reader Question
Reader Question
Comment:I am writing a book on natural treatments for prostate problems. One of my chapters is on prostate cancer. In that chapter I caution men not to take DHEA. In Dr. O’Mathúna’s article titled "DHEA Supplementation During Menopause" (Alternative Medicine Alert, October 1999, pp. 113-116), he alludes to testosterone and prostate cancer risk. However, he fails to mention that DHEA may increase the risk of prostate cancer.1,2 Furthermore, DHEA increases the level of IGF-1. This increases the risk of prostate cancer and female breast cancer. According to one study, men with the highest levels of IGF-1 had a 41/2 times greater risk of developing prostate cancer: For those over the age of 60, the risk was eightfold.3 IGF-1 also stimulates prostate cancer cells to make a substance that promotes tumor cell growth (called urokinase-type plasminogen activator).4 Finally, IGF-1 increases tumor growth by supporting angiogenesis (the formation of new blood vessels).5
Mark W. McClure, MD
Raleigh, NC
References
1. Morales AJ, et al. Effects of replacement dose of dehydroepiandrosterone in men and women of advancing age. J Clin Endocrinol Metab 1994;76:1360-1367.
2. Jones JA, et al. Use of DHEA in a patient with advanced prostate cancer: A case report and review. Urology 1997;50:784-788.
3. Chan JM, et al. Plasma insulin-like growth factor-1 and prostate cancer risk: A prospective study. Science 1998;279:563-566.
4. Miyake H, et al. Elevation of serum levels of urokinase-type plasminogen activator and its receptor in associated with disease progression and prognosis in patients with prostate cancer. Prostate 1999;39:123-129.
5. Nakao-Hayashi J, et al. Stimulatory effects of insulin and insulin-like growth factor 1 on migration and tube formation by vascular endothelial cells. Atherosclerosis 1992;92:141-149.
Response: Thank you for sharing these concerns. Because of space constraints, the focus of my article was on women's health, and I was only able to summarize briefly these important concerns. However, they give added weight to our conclusion that it remains premature to recommend DHEA.
Dónal P. O’Mathúna, PhD
Professor of Bioethics and Chemistry
Mount Carmel College of Nursing, Columbus, OH
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