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25.06.2010

Lancet 1986: link between prostate cancer and steroids in bodybuilder

Review articles on the risks of using steroids when it comes to prostate cancer usually refer to an article published in 1986 in The Lancet. They have to. If you search PubMed for studies in which steroids use led to prostate cancer in athletes, the Lancet article is the only publication you'll find.

The publication is actually a letter written by 2 British doctors from Newcastle-upon-Tyne. The authors describe the case of a 38-year-old ex-stripper and bodybuilder, who earned a living from running a gym. The man went to a doctor when he developed problems urinating. A minor surgical intervention in his bladder helped the problem, but 2 years later the symptoms returned. The doctors then decided to remove part of the man's prostate.

The prostate is a gland that men have in the pelvic area. The urethra runs through the gland. If the prostate grows, the urethra can become constricted. Prostate enlargement in young men is usually benign. If problems arise with urination, part of the prostate can usually be removed to provide relief.

When doctors examined the tissue from the man's prostate, they discovered that it was not benign at all. They found an aggressive form of prostate cancer. Scans showed that the cancer had already spread to the wall of the bladder.

Prostate cancer is not rare. The main risk factor is age. Post mortems carried out on deceased 50-year-olds show a 30 percent rate of prostate cancer. Post mortems done on men who have died in their seventies show a rate of up to 80 percent. The average age at which someone hears that he has cancer is 70. But prostate cancer in someone of 38? The first thing you'd think of would be exposure to a carcinogenic substance like cadmium.

In the bodybuilder's case this had not happened. But he had been using steroids since 1966, when he was 16 years old. By his own admission, he had taken about 15 courses of steroids, with at least six months between each course. He had used nandrolone and methandienone, which at that time were still prescribed by British doctors. And the man had bought stanozolol, fluoxymesterone [structural formula shown here], mesterolone and testosterone on the black market and in pharmacies abroad.

The doctors found a couple of cases in the medical literature describing steroids users who had developed prostate cancer. These concerned men who had used mesterolone or fluoxymesterone to improve their sex lives.

"We feel that exposure to anabolic steroids over a period of 18 years may have played a role in initiating or promoting this man's prostatic cancer", the doctors concluded after assessing the evidence they could find.

And that's all there is. As 'evidence' that steroids use increases the chance of developing prostate cancer we'd agree, it's on the meagre side.

Source:
Lancet. 1986 Sep 27; 2(8509): 742.

More:
Testosterone supplement causes aggressive prostate cancer 16.04.2009