Dr. Rouzier Sets the Record Straight on Hormones and Cancer:
Hormone expert Neal Rouzier, M.D. had a recent discussion with a Physician enquiring about certain hormones and their relationship to cancer. He thought it was worth sharing, and we agree.
Dear John Doe,
I do not know why your tumor marker is elevated but you have had it elevated for some time. We do not use tumor markers here [in the U.S.] to diagnosis cancer. We only use them to monitor the progression of cancer once it is treated with chemo. Tumor markers can be elevated in normal people that don’t have tumors or cancer, so it is not a good diagnostic modality. If you are concerned, then do an upper and lower endoscopy. In addition, a PET CT scan will pick up any cancer that you may have. I doubt that you have cancer and I truly believe that the elevated tumor marker is not diagnostic of cancer. We see them elevated all the time and never indicate a cancer. Again we use them to monitor a cancer once it is diagnosed, but never to diagnosis them. The only marker that we use is the PSA and that is not diagnostic for cancer but makes us go further to R/O any cancer.
The Effect of Testosterone on Cancer Risk
With all due respect, the Japanese doctor that suggests that HRT causes cancer is perhaps unaware of the medical literature. Testosterone does not cause cancer. It may cause it to grow once prostate cancer is established, but no study shows that testosterone causes the cancer. On the contrary, our studies show that higher levels of testosterone are associated with a decreased risk of prostate cancer and less severe types of cancer if one develops a cancer. In fact low levels of testosterone are associated with a greater risk of prostate cancer and a more severe and aggressive type of prostate cancer. We used to think, and many of us were taught, that testosterone causes cancer whereas the overwhelming evidence shows the opposite. Several recent studies showed that testosterone treatment decreased morbidity and mortality from all causes, including heart disease and all cancer. The theory is that testosterone decreases insulin resistance and diabetes which greatly enhances the formation of many cancers. There are several recent studies where researchers (Morganthaler) are treating men with active prostate cancer and are seeing no increase in growth of these cancers. A meta-analysis study reviewed the world’s literature and the conclusion from a multidisciplinary team of specialists concluded that there is no evidence from all the studies that testosterone administration causes cancer. Articles from all specialty journals from endocrinology, urology, cancer, and epidemiology, all published that testosterone does not cause cancer, and in most circumstances, protects against cancer.
The fact that a famous Japanese doctor claims that testosterone causes cancer is very incorrect and not supported by any clinical or scientific evidence. What is more disconcerting is that this physician is misinforming, and perhaps scaring, many Japanese doctors into not prescribing or recommending testosterone which is doing just the opposite of what he has intended. It may increase the morbidity and mortality of many doctors who now resist taking testosterone. I never suggest, teach, lecture, or make any claim unless what I state can be very well supported by scientific evidence. May I make the same suggestion to your fellow physician before he makes reference to hormones causing cancer.
Fear Stemmed from the WHI Trials
It is very true that a synthetic female hormone (medroxyprogesterone acetate or Provera in this country) was demonstrated to cause breast cancer in women. We should not extrapolate this to include all hormones. Most physicians in this country also think that hormones cause cancer, so your famous physician is not too far off base from them. The medical and lay media in this country have scared all women into thinking that hormones cause cancer and this is very unfortunate. It is very true that our synthetic hormones have increased the risk of breast cancer and this has been demonstrated in many studies. As a result of this, there is an inherent fear that hormones cause cancer and there is a human tendency to extrapolate this to include all hormones. The medical literature supports that this is entirely not true. There are two Japanese Physicians that have recently attended Part II of the hormone courses that we offer here in the U.S. They both have the syllabus and 2 hour lecture material that I presented that demonstrates that the hormones in our body do not cause cancer in spite of the inherent fear instilled in us by the media and extrapolation from the WHI trial. Please contact them so that they may present to you all of the literature so that you may come to understand that the hormones in our body do not cause cancer, when in fact they are protective against cancer.
A Brief Summary of the WHI Studies
Without going into detail, I will summarize these studies. A meta-analysis of estrogen demonstrated that estrogen (alone and not with MPA mentioned above) administration decreases morbidity and mortality from all cause, both coronary artery disease, cancer, and osteoporosis. The WHI trial demonstrated that estrogen alone (that was the CEE arm that did not include MPA with the estrogen) was not associated with breast cancer. A most recent analysis just published demonstrated a statistically significant decrease (yes decrease) incidence of breast cancer in those that took estrogen alone in comparison with placebo. In addition, let us not forget that the estrogen only arm demonstrated a significant 27% decrease in colon cancer also. The theory is again the decrease in visceral fat and protection against diabetes that may play a major role in cancer protective effects of estrogen, similar to that of testosterone mentioned above.
The Protective Effects of Estrogen
Except in certain circumstances, which is beyond the scope of this letter, estrogen protects against heart disease, strokes, Alzheimer’s, dementia, osteoporotic fractures, and cancer as proved in the meta-analysis along with a decrease in morbidity and mortality from all cause including cancers. Based on this, would you like your wife, mother, sister to be on estrogen or not? It is very unfortunate that your doctors and the world misinterpret the hormones and cancer issue.
The Difference: Bioidentical vs. Synthetic
There is a plethora of data and studies that demonstrate increased longevity and decreased morbidity and mortality when levels of our hormones are maintained at optimal. This benefit applies to estrogen, testosterone, progesterone, DHEA, and growth hormone. As our hormone levels fall with age, so does the protection against cancer. Replacement of hormones reverses this harm. Replacement with chemically altered hormones (medroxyprogesterone and norethindrone) has always increased the risk of cancers. As per the medical literature, we must not equate them to be the same nor should your doctor. I certainly hope that this lengthy explanation reverses your misunderstanding and that you can pass this along to your fellow physicians.
Neal Rouzier, M.D.