I was still giddy when I decided to look up the article detailing the
experience of testosterone administration to men with metastatic disease
from the Memorial Sloan Kettering Cancer Institute, published in 1981
by the urologic giant of his day, Willet Whitmore, and his colleague,
Jackson Fowler. The short summary of the paper was quite damning. Over a
course of eighteen years, fifty-two men with metastatic disease had
undergone treatment with daily T injections, usually as a last-gasp
treatment for their cancer. Of these fifty-two men, forty-five had
experienced an “unfavorable response,” most within the first month of
treatment.Test E (Test P) powder supplier
This seemed pretty grim. Maybe Huggins had been right after all, despite
basing his conclusions on a solitary patient. But then I discovered
something equally shocking in the fine print of this article. Of the
fifty-two men studied, all but four had already been treated with
castration or estrogen treatment to lower testosterone. And of these
four previously untreated men, one had an early, unspecified unfavorable
response, while the remaining three men continued to receive daily T
injections for 52, 55, and 310 days without apparent negative effects.
In fact, one of these men was reported to have had a “favorable
response” to T administration.
Drs. Fowler and Whitmore were impressed by the difference in outcomes
for the untreated group of four men compared with the men who had
already undergone hormonal treatment to lower testosterone. To explain
the lack of negative effects on the untreated men, the authors
postulated the following: “Normal endogenous testosterone levels may be
sufficient to cause near maximal stimulation of prostatic tumors.” In
other words, raising testosterone levels beyond the normal range did not
seem to cause any increased cancer growth, even in men with metastatic
disease!
This important concept was lost in the headline of the study, which
clearly indicated that giving testosterone to men with prostate cancer
was associated with rapid onset of negative consequences in most men.
One had to read the article closely to learn that the headline applied
only to men who had been previously castrated. Although this article has
been cited for many years as evidence that T administration causes
rapid and near-universal growth of prostate cancer (PCa), the authors in
fact clearly made the point that the worrisome effects of T
administration did not appear to occur in their small group of men
without prior hormonal treatment.
