HRT/TRT: a controversial choice

[MuscleInk]

The primary risks with any hormone manipulation are cardiovascular - blood clots, strokes, poor lipid levels (elevated LDL, low HDL), hypertension, bone weakening (more of an estrogen issue), and impaired wound healing and immune function (again, this has more to do with estrogen issues that testosterone). Many of these risks can be managed by EFFECTIVE weight management and where indicated, drug intervention (for lipids, hypertension, etc.). One of the issues with hormone therapy, particularly in aging is that many people (exceptions apply to this forum of course) are sedentary and make poor life style choices. Unless someone has been living under a rock, we all know that exercise, better food choices, and moderation, are important for longevity. Unfortunately, too many people want a pill to fix everything. They don't exercise enough, don't consume enough fresh fruits and vegetables, they eat far too much simple sugar, and lack the necessary insoluble and soluble fiber to help with cholesterol and weight management.

The cacner risks (breast in women AND men; prostate for men) are more related to estrogen levels, however, elevated testosterone converted to DHT will readily bind to prostate androgen receptors and promote cell growth which in some cases may be mutagenic leading to growth of neoplasias (tumor cell lines).

With proper weight management and diet, which is what we preach around here more than ANYTHING else, many of the risks with hormone therapies can be adequately managed and in many cases, eliminated. Exercise, a healthy lifestyle choice and maintaining a LOW body fat (below 15%) are key to avoiding many affirmatives of aging and living longer.

[Slacker78]

The primary risks with any hormone manipulation are cardiovascular - blood clots, strokes, poor lipid levels (elevated LDL, low HDL), hypertension, bone weakening (more of an estrogen issue), and impaired wound healing and immune function (again, this has more to do with estrogen issues that testosterone). Many of these risks can be managed by EFFECTIVE weight management and where indicated, drug intervention (for lipids, hypertension, etc.). One of the issues with hormone therapy, particularly in aging is that many people (exceptions apply to this forum of course) are sedentary and make poor life style choices. Unless someone has been living under a rock, we all know that exercise, better food choices, and moderation, are important for longevity. Unfortunately, too many people want a pill to fix everything. They don't exercise enough, don't consume enough fresh fruits and vegetables, they eat far too much simple sugar, and lack the necessary insoluble and soluble fiber to help with cholesterol and weight management.

The cacner risks (breast in women AND men; prostate for men) are more related to estrogen levels, however, elevated testosterone converted to DHT will readily bind to prostate androgen receptors and promote cell growth which in some cases may be mutagenic leading to growth of neoplasias (tumor cell lines).

With proper weight management and diet, which is what we preach around here more than ANYTHING else, many of the risks with hormone therapies can be adequately managed and in many cases, eliminated. Exercise, a healthy lifestyle choice and maintaining a LOW body fat (below 15%) are key to avoiding many affirmatives of aging and living longer.

Good answers bro.

But, for what concern breast cancer, which in most of cases strongly related to estrogens, an HRT would increase the risk to lead to cancer developing. It's established that a long estrogens exposure - in sensitive subjects - may increase the risk to get a cancer ( ovarian or breast cancer as we are talking about estrogens sensitive cancers ).

[MuscleInk]

Good answers bro.

But, for what concern breast cancer, which in most of cases strongly related to estrogens, an HRT would increase the risk to lead to cancer developing. It's established that a long estrogens exposure - in sensitive subjects - may increase the risk to get a cancer ( ovarian or breast cancer as we are talking about estrogens sensitive cancers ).

Yes, many of the ovarian and breast cancers are mediated by estrogen pathways, which is why many therapies for breast and ovarian cancers involve anti mitotic (chemotherapy) and aromatase inhibitors such as tamoxifen, femara, anastrazole, exemstane. Unfortunately, to say that these cancers are simply estrogen mediated, is a bit of an over simplification. There are many molecular pathways upstream and downstream in tumor pathology that are also targets for interrupting tumor cell growth. Tyrosine kinases are a popular target as are vascular endothelial growth factors. One of the reasons it is difficult to cure cancer is that cancer is like a dirty bomb. There are so many pathological mechanisms involved in attacking the host, that shutting down one or two pathways only slows disease progression. It doesn't arrest/stop it.

Many hormone therapies directed at estrogen and progesterone are marginally effective and eventually second and third line therapies become necessary as the cancer progresses. The key to successful cancer management is prevention and when that is not possible, early detection is the next best bastion of hope for eradicating the disease. In early stages (1a,b-2a,b) many tumors are localized and can be reduced in size through radiation, chemotherapy, targeted therapy, any combination of those, and then surgical resection (i.e. removing the tumor). If a surgical resection results in negative margins (meaning there are no remaining tumor cells in the surrounding peripheral tissue), the disease is generally "cured".

Unfortunately, many cancer patients remain asymptomatic until the reach stage 2b or 3a, at which time, the tumor lines innervate surrounding tissue, enter lymph nodes and travel through the lymphatic system to other viscera (usually liver and brain) and bone. This is called tumor metastasis, and once this happens, curing the disease is impossible and treatment focuses on increasing the life span of the patient for as long as possible until palliative care becomes the final option.

That's probably much more than you ever cared to know about tumor progression and pathology! lol.