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        <p>
            <span>"...simultaneous treatment of intact...rats with testosterone and estradiol-17beta for 16 weeks
                consistenly induced a putative precancerous lesion, termed dysplasia, in the dorsolateral prostate of
                all animals.&nbsp; Since treatment of rats with androgen alone did not elicit the same response, we
                concluded that estrogen played a critical role in the genesis of this proliferative
                lesion."&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<span>Shuk-mei Ho and M. Yu, in "Selective increase in
                    type II estrogen-binding sites in the dysplastic dorsolateral prostates of Noble rats," Cancer
                    Research 53, 528-532, 1993.</span></span>
        </p>
        <p><span><hr /></span></p>
        <h1>Prostate Cancer</h1>
        <p>
            It was noticed several decades ago that estrogen causes the prostate gland to enlarge in experimental
            animals, but by then an oversimplified view of the sex hormones was already well established, that led
            people to say that "estrogen causes the female organs to grow, and testosterone causes the male organs to
            grow."&nbsp; Logically extending this mistaken idea led many of the same people to suppose that the
            "hormones of one sex would inhibit the growth of the reproductive organs of the other sex."
        </p>
        <p>
            When a friend of mine was told he had prostate cancer, though he had had no symptoms, and should receive
            large doses of estrogen, I reviewed the literature, to see whether his doctor might have seen something I
            had neglected.&nbsp; Since that time, I have found it necessary to use quotation marks around the phrases
            "medical research" and "medical science," because there is a certain kind of "research" performed within the
            medical profession which is peculiar to that profession.
        </p>
        <p>
            When I read through the studies cited by the current articles as the basis for using estrogen to treat
            prostate cancer, I saw that the decisive "research" had consisted of mailing a questionnaire to physicians
            asking them if they thought it was reasonable to administer estrogen to these patients on the basis of its
            opposition to testosterone, which was considered to be responsible for the growth of the prostate
            gland.&nbsp; Many physicians answered the questionnaire affirmatively.
        </p>
        <p>
            If the questioner's purpose was to determine his legal status in using a treatment, his research method was
            appropriate, to see whether the treatment seemed reasonable to others in the profession.&nbsp; Legally, a
            physician is safe if he can count on others to testify that his practice is standard.&nbsp; Unfortunately,
            for generations his study of the opinions of his peers became the "evidence" of the value of the estrogen
            treatment.&nbsp; Phrases such as "it is indicated," "treatment of choice," and "standard practice" are used
            in medicine, as part of the pseudo-scientific mystique of the profession.&nbsp; Physicans who attempt to
            base their practice on methods that have a sound scientific basis are likely to find that they are violating
            the norms of their profession.
        </p>
        <p>
            More than 25 years ago, when I started pointing out that deliberate misrepresentation had been involved in
            the continued designation of estrogen as "the female hormone," used as a basis for "hormone replacement
            therapies," I saw that it was hard for people to sustain a critical attitude toward language.&nbsp; Language
            is prior to judgment, law, science, reason.&nbsp; Those who define the terms set the rules.
        </p>
        <p>
            By the mid-1980s, some studies had shown that estrogen treatment didn't prolong the survival of prostate
            cancer patients at all, but it was argued that the patients who received estrogen were happier than those
            who didn't.
        </p>
        <p>
            Apparently, many physicians who were experts in conventional cancer treatment hadn't been impressed by the
            happiness of their patients who were receiving estrogen, because a survey at a conference of physicians
            found that many of them would choose to have no treatment if they learned they had prostate cancer.&nbsp;
            And more recently, there have been recommendations that older patients shouldn't be treated aggressively,
            because their cancers are usually so slow growing that they are likely to die of something else related to
            old age.
        </p>
        <p>
            In spite of the articles I showed my friend, and my warning that estrogen can cause strokes and heart
            attacks, he decided to take the estrogen treatment.&nbsp; Within a few days he began suffering from asthma
            and disturbed sleep.&nbsp; Then he had a series of strokes and died.&nbsp;
        </p>
        <p>
            Since it was known that estrogen treatment was dangerous for men, and that it increases blood clotting and
            vascular spasms, there had to be some overriding belief that led to its general use in treating prostate
            cancer.&nbsp; That belief seems to be that "estrogen, the female hormone, opposes testosterone, the male
            hormone, which is responsible for the growth--and therefore for the cancerization--of the prostate
            gland."&nbsp; Everything is wrong with that sentence, but you can find every part of the belief present and
            functioning in the medical literature.&nbsp; Just to give some context to the association of growth and
            cancerization, I should mention that Otto Warburg observed that all of the carcinogenic factors he studied
            caused&nbsp;<span>tissue atrophy before cancer</span>&nbsp;appeared.&nbsp; Another important contextual
            point is that every hormone does&nbsp;<span>many&nbsp;</span>things, and every endocrine gland produces
            multiple hormones.
        </p>
        <p>
            Since the time of Brown-Sequard and Eugen Steinach, it has been accepted that declining testicular function
            is a common feature of aging, and testosterone was probably the first hormone that was clearly found to
            decrease consistently with aging.&nbsp; (Vermeulen, et al., 1972, 1979.)&nbsp;
        </p>
        <p>
            It has seemed odd to many people that enlargement of the prostate should occur mainly in older men, if
            testosterone is the hormone that causes its growth, and estrogen is antagonistic to its growth.&nbsp; The
            nature of the growth of the old man's prostate is very different from its natural growth in youth.
        </p>
        <p>
            It was also recognized decades ago that estrogen rises in men during old age (Pirke and Doerr, 1975), as it
            rises in stress, disease, malnutrition, and hypothyroidism (which are also associated with old age).&nbsp;
            Estrogen is produced in fat (Siiteri, and MacDonald, 1973, Vermeulen, 1976) which tends to increase with
            age, when thyroid and progesterone are deficient.&nbsp; The conversion of testosterone to estrogen occurs in
            the testicle itself, but this conversion is also inhibited by the favorable hormonal environment of
            youth.<span>&nbsp;&nbsp;</span>The active thyroid hormone, T<sub>3</sub>
            <span><sub>,&nbsp;</sub></span>declines with aging, and this necessarily lowers production of pregnenolone
            and progesterone.&nbsp; Increasingly, in both sexes, it appears that DHEA may rise during stress as a result
            of a deficiency of thyroid, progesterone, and pregnenolone.
        </p>
        <p>
            In 1786, John Hunter reported that castration causes a decrease in the size of the prostate gland, and by
            the end of the 19th century castration was being advocated for treating enlargement of the prostate.&nbsp;
            In aging men, the prostate gland (both central and peripheral zones) atrophies, and it is within the
            atrophic gland that cancer cells can be found.&nbsp; Nodular, noncancerous enlargement may occur, with or
            without cancer.&nbsp; In 1935, an autopsy study showed carcinoma in the prostates of 30% of men by the age
            of 50.&nbsp; Proliferation of ductal and epithelial tissue is closely associated with prostate cancer, a
            situation similar to that of the cancerous or precancerous breast.&nbsp; (Simpson, et al., 1982; Wellings,
            et al., 1975; Jensen, et al., 1976.)&nbsp; The high probability of "epitheliosis" in association with cancer
            was seen in women in their early 40s, and in women over 60. (Simpson, et al.)&nbsp; (Epitheliosis just
            refers to an exaggerated proliferation of epithelial cells, the cells covering all surfaces, including the
            lining of glands, and things as simple as irritation and vitamin A deficiency can cause these cells to
            proliferate.)&nbsp; In the breast, the proliferative epitheliosis is clearly caused by estrogenic
            stimulation.&nbsp; The antagonism between estrogen and vitamin A in controlling epithelial proliferation
            (and possibly other cell types<span>:</span>&nbsp;Boettger-Tong and Stancel, 1995) is clear wherever it has
            been tested<span>;</span>&nbsp;vitamin A restrains epithelial proliferation.&nbsp; (Wherever estrogen is a
            factor in the development of abnormal tissue, vitamin A supplementation would seem beneficial.)
        </p>
        <p>
            <span>&nbsp;</span>In aging women and men, as the breasts and prostate atrophy, their estrogen/antiestrogen
            ratio increases.
        </p>
        <p>
            In men with prostate cancer, the fluid secreted by the prostate contains significantly more estradiol than
            the fluid from men without cancer (Rose, et al., 1984).&nbsp; This is analogous to observations made in
            women with breast cancer.
        </p>
        <p>
            The pituitary hormones have diverse functons, including effects on epithelial tissues, other than their
            "classical" functions.&nbsp; Growth hormone, ACTH (Lostroh and Li, 1957), and ACTH with prolactin (Tullner,
            1963) stimulate prostate growth.&nbsp; Prolactin--which is increased by estrogen--stimulates growth of the
            rat's lateral prostate (Holland and Lee, 1980), and stimulates the growth of human prostate epithelial
            cells&nbsp;<span>in vitro</span>&nbsp;(Syms, et al., 1985).&nbsp; LH (luteinizing hormone) increases when
            progesterone or testosterone is deficient, and growth hormone and prolactin (which are closely associated in
            evolution) both increase under a variety of stressful situations, and with estrogenic
            stimulation.&nbsp;&nbsp;<span>Prostate cancer patients who had higher levels of LH and&nbsp;</span>
            <span>lower testosterone</span>
            <span>&nbsp;died most quickly.&nbsp; (Harper, et al., 1984.)&nbsp; Also, a&nbsp;</span>
            <span>high ratio of testosterone to estradiol or of testosterone to prolactin</span>
            <span>&nbsp;corresponded to better survival (Rannikko, et al., 1981.)&nbsp; Considered separately, patients
                with&nbsp;</span>
            <span>higher testosterone levels had a better prognosis</span>
            <span>&nbsp;than those with lower levels, and patients with lower growth hormone&nbsp;</span>levels did
            better than those with higher growth hormone levels. (Wilson, et al., 1985.)&nbsp; Has anyone ever tried
            testosterone therapy for prostate cancer?&nbsp; Or, more practically, a generalized antiestrogenic therapy,
            using thyroid, progesterone, and pregnenolone?&nbsp; Other drugs (naloxone, bromocriptine,
            gonadotropin-releasing hormone agonists, and anti-growth hormone druges, e.g.) are available to regulate the
            pituitary hormones, and might be useful therapeutically or preventively.&nbsp; (See Blaakaer, et al.,
            1995.)&nbsp; Biskind and Biskind's work (1944) with ovarian tumors might be relevant to both testicular and
            prostate cancer.
        </p>
        <p>
            Abnormal patterns of pituitary hormones reflect stress and hormonal imbalance, but they are also directly
            involved in widespread changes in tissue content of glycoproteins.&nbsp; The prostate is specialized to
            secrete large amounts of mucin.&nbsp; The endocrine physiology of prostate mucin secretion is poorly
            understood, but it is likely that there are interactions between growth-regulatory and secretion-regulatory
            systems.
        </p>
        <p>
            In recent years, prostate cancer has been one of the fastest increasing kinds of cancer, and it isn't
            apparent that increased treatment has had an effect in lowering the death rate.&nbsp; The postwar baby-boom
            (following the baby-bust of the great depression) created an abnormal age-structure of the population, that
            has been used to argue that the war against cancer is being won.&nbsp; Increasing environmental estrogens
            are known to cause many reproductive abnormalities, and their contribution to prostate cancer would get more
            attention if estrogen's role in prostate disease were better known.&nbsp; Environmental estrogens are
            clearly responsible for genital deformities and sterility in many species of wild animals, but when the
            causal link is made between estrogens and human abnormalities, the estrogen industry sends its shills in to
            create controversy and confusion.&nbsp; Even the effects of estrogens in sewage, known for decades, are
            treated as State Secrets:&nbsp; "There had been reports of hermaphroditic fishes in one or two rivers, and
            government investigators had been studying them since the late 1970s.&nbsp;&nbsp;<span>But no one had been
                aware of the work because it was classified."</span>&nbsp;(Lutz, 1996.)
        </p>
        <p>
            Testicular cancer is easy to diagnose, and its incidence has clearly increased (100% in white men, 200% in
            black men) since 1950.&nbsp; Undescended testicles, urethral abnormalities, etc., similar to those seen in
            DES sons and in wild animals, have also increased.&nbsp; So the tremendous increase in the death rate from
            prostate cancer during the same time has a meaningful context.
        </p>
        <p>
            Although the animal studies showed that estrogen treatment promotes enlargement of the prostate, it was
            possible to suppose that the human prostate's growth might be stimulated only by testosterone, until tests
            were done&nbsp;<span>in vitro</span>&nbsp;to determine the effects of hormones on cell division.
        </p>
        <p>
            In human prostate slices, several hormones (including insulin, and probably prolactin) stimulated cell
            division<span>;</span>&nbsp;<span>testosterone did not,</span>&nbsp;under these experimental conditions.
            (McKeehan, et al., 1984.) Contrary to the stereotyped ideas, there are suggestions that supplementary
            androgens could control prostate cancer (Umekita, et al., 1996), and that antagonists to prolactin and
            estrogen might be appropriately used in hormonal therapy (for example, Wennbo, et al., 1997; Lane, et al.,
            1997).
        </p>
        <p>
            By the age of 50, men often show an excess of both prolactin and estrogen, and a deficiency of thyroid and
            testosterone.&nbsp; This is the age at which enlargement of the prostate often becomes noticeable.
        </p>
        <p>
            Estrogen's role in prostate growth and cancerization is clear<span>:</span>&nbsp; "<span>...</span
            >simultaneous treatment of intact...rats with testosterone and estradiol-17beta for 16 weeks consistenly
            induced a putative precancerous lesion, termed dysplasia, in the dorsolateral prostate of all animals.&nbsp;
            Since treatment of rats with androgen alone did not elicit the same response, we concluded that estrogen
            played a critical role in the genesis of this proliferative lesion."&nbsp; (Ho and Yu.)
        </p>
        <p>
            Progesterone and pregnenolone also decline in aging men.&nbsp; Several studies using synthetic progestins
            have shown that they effectively shrink the hypertrophic prostate, and the saw palmetto remedy for prostate
            enlargement has been reported to contain pregnenolone, or something similar to it.&nbsp; These materials
            might be expected to reduce conversion of testosterone or other androgens to estrogen.
        </p>
        <p>
            The prostaglandins were discovered in prostatic fluid, where they occur in significant concentrations.&nbsp;
            They are so deeply involved with the development of cancers of all sorts that aspirin and other
            prostaglandin inhibitors should be considered as a basic part of cancer therapy.&nbsp; The prostaglandins
            have local and systemic effects that promote cancer growth.&nbsp; ("The prostaglandins and related
            eicosanoids synthesized from polyunsaturated fatty acid precursors have been implicated as modulators
            of&nbsp;<span>tumor metastasis, host immunoregulation, tumor promotion, and cell proliferation."</span
            >&nbsp; Hubbard, et al., 1988.)
        </p>
        <p>
            Estrogens cause elevation of free fatty acids, and&nbsp; there are many interactions between the unsaturated
            fatty acids and estrogen, including their metabolism to prostaglandins, and their peroxidation.&nbsp;
            Estrogen's roles as free-radical promoter, DNA toxin, carcinogen, tumor promotor, modifier of tissue growth
            factors, anti-thymic hormone, etc., as well as its local effects on the prostate gland, have to be kept in
            mind.&nbsp; Most of the interest in studying estrogen's contributions to prostate cancer relates to the
            existence of estrogen receptors in various parts of the prostate.&nbsp; While that is interesting, it tends
            to distract attention from the fact that many of estrogen's most important actions don't involve the
            "receptors."&nbsp; A&nbsp;<span>direct excitatory</span>&nbsp;action on prostate cells, and&nbsp;<span
            >indirect</span>&nbsp;actions by way of the pituitary, pancreas, thyroid, adrenal, fatty acids,
            prostaglandins, histamine and circulation are probably essential parts of the cancerization process.
        </p>
        <p>
            The unsaturated fatty acids, but not the saturated fatty acids, free estrogen from the serum proteins that
            bind it, and increase its availability and activity in tissue cells.
        </p>

        <p>
            Thyroid supplementation, adequate animal protein, trace minerals, and vitamin A are the first things to
            consider in the prevention of prostate hypertrophy and cancer.&nbsp; Nutritional and endocrine support can
            be combined with rational anticancer treatments, since there is really no sharp line between different
            approaches that are aimed at achieving endocrine and immunological balance, without harming anything.
        </p>
        <p>
            Avoiding tissue atrophy is very closely related to promoting healthy regeneration.&nbsp; These processes
            require efficient energy production, and an appropriate balance between stimulation and resources.&nbsp;
            Growth hormone is sometimes recommend to correct tissue atrophy, but the evidence seems reasonably clear
            that it is a factor in the promotion of tumefaction of the prostate.&nbsp; The only study I have seen
            suggesting that it might be beneficial in prostatic cancer was a 14 day experiment done in female
            rats.&nbsp; Numerous publications suggest that blocking growth hormone is beneficial in treating prostate
            cancer<span>;&nbsp;</span>in future newsletters I will be discussing the evidence that growth hormone, like
            estrogen, cortisol, and unsaturated fats, tends to promote degenerative changes of aging - <a
                href="http://raypeat.com/articles/articles/growth-hormone.shtml"
            >Growth hormone: Hormone of Stress, Aging, and Death?</a>
        </p>
        <p>&nbsp;</p>
        <p>&nbsp; &nbsp;&nbsp;<span><h3>REFERENCES</h3></span></p>
        <p>&nbsp;</p>
        <p>
            <span>M.C. Audy, et al., "17beta-Estradiol stimulates a rapid Ca2+ influx in LNCaP human prostate cancer
                cells," Eur. J. Endocrionol.135, 367-373, 1996.</span>
        </p>
        <p>
            <span>M. S. Biskind and G. S. Biskind, "Development of tumors in the rat ovary after transplantation into
                the spleen," Proc. Soc. Exp. Biol. Med. 55, 176-179, 1944.</span>
        </p>
        <p>
            <span>J. Blaakaer, et al., "Gonadotropin-releasing hormone agonist suppression of ovarian tumorigenesis in
                mice of the W<sup>x</sup>/W<sup>v</sup>&nbsp;genotype," Biol. of Reprod. 53, 775-779, 1995.</span>
        </p>
        <p>
            <span>Clinton, SK Mulloy AL, Li SP, Mangian HJ, Visek WJ, J Nutr 1997 Feb;127(2):225-237 "Dietary fat and
                protein intake differ in modulation of prostate tumor growth, prolactin secretion and metabolism, and
                prostate gland prolactin binding capacity in rats."&nbsp;</span>
        </p>
        <p>
            <span>J. R. Drago, "The induction of Nb rat prostatic carcinomas," Anticancer Res. 4, 255-256, 1984.</span>
        </p>
        <p>
            <span>J. Geller, et al., "The effect of cyproterone acetate on adenocarcinoma of the prostate," Surg. Gynec.
                Obst. 127, 748-758, 1968.</span>
        </p>
        <p>
            <span>J. Geller, J. Fishman, and T. L. Cantor, "Effect of cyproterone acetate on clinical, endocrine and
                pathological features of benign prostatic hypertrophy," J. Steroid Biochemistry 6, 837-843, 1975.</span>
        </p>
        <p>
            <span>Ho, Shuk-mei, and M. Yu, "Selective increase in type II estrogen-binding sites in the dysplastic
                dorsolateral prostates of Noble rats," Cancer Research 53, 528-532, 1993.&nbsp; "...simultaneous
                treatment of intact...rats with testosterone and estradiol-17beta for 16 weeks consistenly induced a
                putative precancerous lesion, termed dysplasia, in the dorsolateral prostate of all animals.&nbsp; Since
                treatment of rats with androgen alone did not elicit the same response, we concluded that estrogen
                played a critical role in the genesis of this proliferative lesion."</span>
        </p>
        <p>
            <span>M. E. Harper, et al., "Carcinoma of the prostate: relationship of pretreatment hormone levels to
                survival," Eur. J. Cancer Clin. Oncol. 20, 477-482, 1984.</span>
        </p>
        <p>
            <span>J. M. Holland and C. Lee, "Effects of pituitary grafts on testosterone stimulated growth of rat
                prostate," Biol. Reprod. 22, 351-355, 1980.</span>
        </p>
        <p>
            <span>W. C. Hubbard, et al., "Profiles of prostaglandin biosynthesis in sixteen established cell lines
                derived from human lung, colon, prostate, and ovarian tumors," Cancer Research 48, 4770-4775,
                1988.&nbsp; "The prostaglandins and related eicosanoids synthesized from polyunsaturated fatty acid
                precursors have been implicated as modulators of tumor metastasis, host immunoregulation, tumor
                promotion, and cell proliferation."</span>
        </p>
        <p>
            <span>Izes JK, Zinman LN, Larsen CR, Urology 1996 May;47(5):756-759 "Regression of large pelvic desmoid
                tumor by tamoxifen and sulindac,"&nbsp; "A 54-year-old man was evaluated for symptoms of bladder outlet
                obstruction. Evaluation revealed a 10 by 9.8-cm tumor composed of bland, fibroblastic, poorly cellular
                material adjacent to the prostate. Administration of a course of&nbsp;<span>antiestrogen (tamoxifen) and
                    a nonsteroidal anti-inflammatory agent (sulindac) resulted in prompt relief of symptoms and a slow
                    decrease in the size of the tumor</span><span>&nbsp;as measured by computed tomography. After 54
                    months of therapy, the tumor was undetectable clinically and dramatically reduced in size as seen on
                    computed tomography. Data on the natural history of desmoid tumors and the efficacy of various
                    therapeutic strategies are reviewed.</span></span>
        </p>
        <p>
            <span>Jungwirth A, Schally AV, Pinski J, Halmos G, Groot K, Armatis P, Vadillo-Buenfil M., Br J Cancer
                1997;75(11):1585-1592, "Inhibition of in vivo proliferation of androgen-independent prostate cancers by
                an antagonist of growth hormone-releasing hormone."</span>
        </p>
        <p>
            <span>Kroes R; Teppema JS Development and restitution of squamous metaplasia in the calf prostate after a
                single estrogen treatment. An electron microscopic study.&nbsp; Mol Pathol, 1972 Jun, 16:3,
                286-301.</span>
        </p>
        <p>
            <span>Lane KE, Leav I, Ziar J, Bridges RS, Rand WM, Ho SM, Carcinogenesis 1997 Aug;18(8):1505-1510&nbsp;
                "Suppression of testosterone and estradiol-17beta-induced dysplasia in the dorsolateral prostate of
                Noble rats by bromocriptine." "We, and others, have previously described the histological changes that
                occur in the prostate gland of intact Noble (NBL) rats following prolonged hormonal treatment.
                Dysplasia, a pre-neoplastic lesion, develops specifically in the dorsolateral prostates (DLPs) of NBL
                rats treated for 16 weeks with a combined regimen of testosterone (T) and estradiol-17beta (E2) (T +
                E2-treated rats).&nbsp;</span>
            <span>Concurrent with DLP dysplasia induction, the dual hormone regimen also elicits hyperprolactinemia, in
                addition to an elevation of nuclear type II estrogen binding sites (type II EBS), no alteration in
                estrogen receptors (ER), and marked epithelial cell proliferation in the dysplastic foci.</span>
            <span>&nbsp;The aim of this study was to investigate whether the dual hormone action is mediated via
                E2-induced hyperprolactinemia. Bromocriptine (Br), at a dose of 4 mg/kg body wt per day, was used to
                suppress pituitary prolactin (PRL) release. Serum PRL levels were lowered from values of 341 +/- 50
                ng/ml in T + E2-treated rats to 32 +/- 10 ng/ml in Br co-treated animals. The latter values were
                comparable to those in untreated control rats. In addition, Br co-treatment effectively inhibited the
                evolution of dysplasia (six out of eight rats)&nbsp;</span>
            <span>and the often associated inflammation</span>
            <span>&nbsp;(five out of eight rats) in most animals. In contrast, Br co-treatment did not suppress the T +
                E2-induced type II EBS elevation nor alter ER levels in the DLPs of these rats, when compared with T +
                E2-treated rats. These data extend the many previous studies that have detailed marked influences
                of&nbsp;</span>
            <span>PRL on rat prostatic functions. However, the current study is the first to implicate PRL in prostatic
                dysplasia induction in vivo.</span>
            <span>"</span>
        </p>
        <p>
            <span>I. Leav, et al., "Biopotentiality of response to sex hormones by the prostate of castrated or
                hypophysectomized dogs:&nbsp; Direct effects of estrogen," Am. J. Pathol., 93, 69-92, 1978.</span>
        </p>
        <p>
            <span>H. C. Levine, et al., "Effects of the addition of estrogen to medical castration on prostatic size,
                symptoms, histology and serum prostate specific antigen in 4 men with benign prostatic hypertrophy<span
                >," J. Urol. 146, 790-93, 1991.</span></span>
        </p>
        <p><span>Diana Lutz, The Sciences, January/February 1996.</span></p>
        <p>
            <span>W. L. McKeehan, et al., "Direct mitogenic effects of insulin, epidermal growth factor, glucocorticoid,
                cholera toxin, unknown pituitary factors and possibly prolactin,<span>but not androgen,</span><span
                >&nbsp;on normal rat prostate epithelial cells in serum-free, primary cell culture," Cancer Res. 44(5),
                    1998-2010, 1984.</span></span>
        </p>
        <p>
            <span>Nevalainen MT, Valve EM, Ingleton PM, Nurmi M, Martikainen PM, Harkonen PL, J Clin Invest 1997 Feb
                15;99(4):618-627 "Prolactin and prolactin receptors are expressed and functioning in human prostate."
                "The highest density of prolactin receptors was detected in the secretory epithelial cells by
                immunohistochemistry. Finally, we report that prolactin is locally produced in human prostate
                epithelium, as evidenced by marked prolactin immunoreactivity in a significant portion of prostate
                epithelial cells, with parallel expression of prolactin mRNA in human prostate. Collectively, these data
                provide significant support for the existence of an autocrine/paracrine loop of prolactin in the human
                prostate and may shed new light on the involvement of prolactin in the etiology and progression of
                neoplastic growth of the prostate."</span>
        </p>
        <p>
            <span>A. J. Lostroh and C. H. Li, "Stimulation of the sex accessories of hypophysectomised male rat by
                non-gonadotrophin hormones of the pituitary gland," Acta endocr. Copenh. 25, 1-16, 1957.</span>
        </p>
        <p>
            <span>F. B. Merk, et al., "Multiple phenotypes of prostatic glandular cells in castrated dogs after
                individual or combined treatment with androgen<span>&nbsp;</span><span>and estrogen,"</span><span
                >&nbsp;Lab. Invest. 54, 42-46, 1986.</span></span>
        </p>
        <p>
            <span>Pirke, K.M. and P. Doerr, "Age related changes in free plasma testosterone, dihydrotesterone, and
                oestradiol," Acta endocr. Copenh. 89, 171-178, 1975</span>
        </p>
        <p>
            <span>S. Rannikko, et al., "Hormonal patterns in prostatic cancer 1. Correlation with local extent of
                tumour, presence of metastases and grade of differentiation," Acta endocr. Copenh. 98, 625-633,
                1981.</span>
        </p>
        <p>
            <span>P. H. Rolland, et al., "Prostaglandins in human breast cancer:&nbsp; Evidence suggesting that an
                elevated prostaglandin production is a marker of metastatic potential for neoplastic cells," J. Natl.
                Cancer Inst. 64, 1061-1070, 1980.</span>
        </p>
        <p>
            <span>D. P. Rose, et al., "Hormone levels in prostatic fluid from healthy Finns and prostate cancer
                patients," Eur. J. Cancer clin. Oncol. 20, 1317-1319, 1984.</span>
        </p>
        <p>
            <span>L. M. Schuman, et al., "Epidemiologic study of prostatic cancer:&nbsp; Preliminary report," Cancer
                Treat. Rep. 61, 181-186, 1977.</span>
        </p>
        <p>
            <span>Siiteri, P.K. and P. C. MacDonald, "Role of extraglandular estrogen in human endocrinology," In
                Handbook of Physiology, section 7, Endocrinology Vol II (Eds. S. R. Geiger, et al.,) pp. 615-629,
                Williams &amp; Wilkins, Baltimore.</span>
        </p>
        <p>
            <span>H. W. Simpson, et al., "Bimodal age-frequency distribution of epitheliosis in cancer mastectomies,
                Cancer 50, 2417-2422, 1982; S. R. Wellings, et al., "Atlas of subgross pathology of the human breast
                with special reference to possible precancerous lesions," J. Nat. Cancer Inst. 55, 231-273, 1975; H. M.
                Jensen, et al., "Preneoplastic lesions in the human breast," Science, N.Y. 191, 295-297,1976.</span>
        </p>
        <p>
            <span>Sugimura Y, Sakurai M, Hayashi N, Yamashita A, Kawamura J., Prostate 1994;24(1):24-32&nbsp;
                "Age-related changes of the prostate gland in the senescence-accelerated mouse." "Wet weight and numbers
                of ductal tips in ventral and dorsolateral prostate glands in senescence accelerated-prone (SA-P) mice
                were significantly smaller than those of senescence accelerated-resistant (SA-R) mice, although the
                changes of patterns of gross ductal morphology were virtually identical in these groups.&nbsp;<span>High
                    incidence of stromal hyperplasia with fibrosis and inflammation</span><span>&nbsp;was observed...."
                    "These data suggest that the aging process occurs heterogeneously within the prostate gland, and
                    that SA-P mice may be an important model for the study of age-related changes in the prostate
                    gland."</span></span>
        </p>
        <p>
            <span>W. W. Tullner, "Hormonal factors in the adrenal-dependent growth of the rat ventral prostate," Nat.
                Cancer Inst. Monograph 12, 211-223, 1963.</span>
        </p>
        <p>
            <span>Umekita Y, Hiipakka RA, Kokontis JM, Liao S, Proc Natl Acad Sci U S A 1996 Oct
                15;93(21):11802-11807&nbsp; "Human prostate tumor growth in athymic mice: inhibition by androgens and
                stimulation by finasteride," "When the human prostate cancer cell line, LNCaP 104-S, the growth of which
                is stimulated by physiological levels of androgen, is cultured in androgen-depleted medium for &gt; 100
                passages, the cells, now called LNCaP 104-R2, are proliferatively repressed by low concentrations of
                androgens. LNCaP 104-R2 cells formed tumors in castrated male athymic nude mice.&nbsp;<span>Testosterone
                    propionate (TP) treatment prevented LNCaP 104-R2 tumor growth and caused regression of established
                    tumors in these mice.</span><span>&nbsp;Such a tumor-suppressive effect was not observed with tumors
                    derived from LNCaP 104-S cells or androgen receptor-negative human prostate cancer PC-3 cells. 5
                    alpha-Dihydrotestosterone,&nbsp;</span><span>but not 5 beta-dihydrotesto- sterone, 17
                    beta-estradiol,</span><span>&nbsp;or medroxyprogesterone acetate, also inhibited LNCaP 104-R2 tumor
                    growth. Removal of TP or implantation of finasteride, a 5 alpha-reductase inhibitor, in nude mice
                    bearing TP implants resulted in the regrowth of LNCaP 104-R2 tumors. Within 1 week after TP
                    implantation, LNCaP 104-R2 tumors exhibited massive necrosis with severe hemorrhage. Three weeks
                    later, these tumors showed fibrosis with infiltration of chronic inflammatory cells and scattered
                    carcinoma cells exhibiting degeneration. TP treatment of mice with LNCaP 104-R2 tumors reduced tumor
                    androgen receptor and c-myc mRNA levels but increased prostate-specific antigen in serum- and
                    prostate-specific antigen mRNA in tumors.</span><span>&nbsp;Although androgen ablation has been the
                    standard treatment for metastatic prostate cancer for &gt; 50 years, our study shows that androgen
                    supplementation therapy may be beneficial for treatment of certain types of human prostate cancer
                    and that the use of 5 alpha-reductase inhibitors, such as finasteride or anti-androgens, in the
                    general treatment of metastatic prostate cancer may require careful assessment."</span></span>
        </p>
        <p>
            <span>A. Vermeulen, "Testicular hormonal secretion and aging in males," in Benign prostatic hyperplasia (J.
                T. Grayhack, et al., eds), pp. 177-182, DHEW Publ. No. (NIH) 76-1113, 1976.</span>
        </p>
        <p>
            <span>A. Vermeulen, et al., "Testosterone secretion and metabolism in male senescence," J. Clin. Endocr.
                Metab. 34, 730-735, 1972.</span>
        </p>
        <p>
            <span>A. Vermeulen, et al., "Hormonal factors related to abnormal growth of the prostate," in Prostate
                Cancer (D. S. Coffey and J. T. Issacs, eds). UICC Technical Workshop Series, Vol 48, 81-92, UICC,
                Geneva.</span>
        </p>
        <p>
            <span>S. Zuckerman and J. R. Groome, "The aetiology of benign enlargement of the prostate in the dog," J.
                Pathol. Bact. 44, 113-124, 1937.</span>
        </p>
        <p>
            <span>B. Zumoff, et al., "Abnormal levels of plasma hormones in men with prostate cancer:&nbsp; Evidence
                toward a 'time-defense' theory," The Prostate 3, 579-588, 1982.</span>
        </p>
        <p>
            <span>M. Wehling, "Non-genomic steroid action--take a closer look, it's not rare!" Eur. J. of Endorinol.
                135, 287-288, 1996.</span>
        </p>
        <p>
            <span>Wennbo H, Kindblom J, Isaksson OG, Tornell J., Endocrinology 1997 Oct;138(10):4410-4415. "Transgenic
                mice overexpressing the prolactin gene develop dramatic enlargement of the prostate gland,"&nbsp; "An
                altered endocrine status of elderly men has been hypothesized to be important for development of
                prostate hyperplasia. The present study addresses the question whether increased PRL expression is of
                importance for development of prostate hyperplasia in mice. Three lines of PRL transgenic mice were
                generated having serum levels of PRL of approximately 15 ng/ml, 100 ng/ml, and 250 ng/ml, respectively.
                These mice developed dramatic enlargement of the prostate gland, approximately 20 times the normal
                prostate weight and they had a 4- to 5-fold increased DNA content. Histologically, the prostate glands
                in the transgenic mice were distended from secretion, and the amount of interstitial tissue was
                increased. The levels oftestosterone and IGF-I were increased in the PRL transgenic animals. In mice
                overexpressing the bovine GH gene, displaying elevated IGF-I levels, the prostate gland was slightly
                larger compared with normal mice, indicating that the effect of PRL was not primarily mediated through
                elevated plasma IGF-I levels. "<span>The present study suggests that PRL is an important factor in the
                    development of prostate hyperplasia</span><span>&nbsp;acting directly on the prostate gland or via
                    increased plasma levels of testosterone."</span></span>
        </p>
        <p>&nbsp;</p>

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