News Tips from the 2004 Annual Meeting of the American Urological Society

HIGH BLOOD TESTOSTERONE LEVELS ASSOCIATED WITH INCREASED PROSTATE CANCER RISK(Embargoed for Sunday, May 9, 2004, at 11 a.m. EDT. The AUA will hold a press conference on this topic in San Francisco on Tuesday, May 11, 2004, at 3 p.m. PDT ) .

Men over 50 years of age with high blood levels of testosterone have an increased risk of prostate cancer, according to a study by researchers at Johns Hopkins and the National Institute on Aging. The finding throws some doubt on the safety of testosterone replacement therapy, the investigators say.

The researchers measured several forms of testosterone in almost 3,000 blood samples collected over a 40-year period from 759 men in the Baltimore Longitudinal Study on Aging, of whom 111 were diagnosed with prostate cancer. One form of testosterone, called free testosterone, which is biologically active and can actually be used by the prostate, was found to be associated with increased prostate cancer risk, according to J. Kellogg Parsons, M.D., instructor of urology at the Brady Urological Institute at Johns Hopkins and lead researcher of the study.

"Since testosterone replacement therapy increases the amount of free testosterone in the blood, older men considering or receiving testosterone replacement should be counseled as to the association until data from long-term clinical trials becomes available," says Parsons.

The association between free testosterone and prostate cancer risk in older men was not affected by height, weight, percent of body fat, or muscle mass. Total testosterone levels and dehydroepiandrosterone sulfate (DHEAS), another androgenic hormone, were also unrelated to prostate cancer risk, while the protein that binds testosterone in blood, called sex hormone-binding globulin (SHBG), was associated with a slightly decreased risk for prostate cancer.

Higher serum free testosterone is associated with an increased risk of prostate cancer: results from the Baltimore longitudinal study on aging. J. Kellogg Parsons, H. Ballentine Carter, Patricia Landis, E. James Wright, Elizabeth Platz, E. Jeffrey Metter.

OBESE MEN MAY HAVE INCREASED RISK FOR PROSTATE CANCER RECURRENCE AFTER SURGERY(Embargoed for Sunday, May 9, 2004, at 11 a.m. EDT. The AUA will hold a press conference on this topic in San Francisco on Tuesday, May 11, 2004, at 11 a.m. PDT). After prostate cancer surgery, obese men are more likely than men with normal weight to have high levels of prostate specific antigen (PSA), a marker for cancer recurrence, according to a study led by Johns Hopkins researchers.

"Our results show that moderately and severely obese men were at an increased risk for high PSA levels after surgery and therefore are likely to have prostate cancer recurrence," said Stephen Freedland, M.D., instructor of urology at the Brady Urological Institute at Johns Hopkins and lead researcher of the study.

The study involved 1,106 patients treated at five Veteran's Administration and active military hospitals across the country. Moderately and severely obese patients -- defined as those having a body mass index (BMI) of greater than 35 kilograms per square meter, or the equivalent of a 5-foot-10 inch man weighing 245 pounds or more -- were found to have several indicators of aggressive prostate cancer, including higher Gleason scores and rising PSA levels after surgery. Men with a BMI of greater than 35 kg/m2 had a 60 percent risk of cancer recurrence within three years. Thirty-one percent of African-American men in the study were obese, while 21 percent of Caucasian men were obese.

"Our findings add to the burgeoning list of chronic and deadly diseases associated with obesity and underscore the importance of this major public health problem," says Freedland.

Obesity is an independent predictor of biochemical failure following radical prostatectomy. Stephen J. Freedland, William J. Aronson, Christopher J. Kane, Joseph C. Presti, Christopher L. Amling, David Elashoff, Martha K. Terris.

AMERICAN UROLOGICAL ASSOCIATION AWARDS HIGHEST HONOR TO UROLOGY CHAIRMAN AT JOHNS HOPKINS

Patrick C. Walsh, M.D., professor of urology and director of the Brady Urological Institute at Johns Hopkins, will receive the American Urological Association's highest honor, the Ramon Guiteras Award, for his "outstanding contributions to the art and science of urology." Walsh will step down as director of the Brady Institute in July - a post he has held since 1974 - but will continue to see patients and perform surgeries full time at Johns Hopkins.

Walsh is widely considered the world's foremost expert on prostate cancer. He is best known for his pioneering work in the development of the anatomic approach to radical prostatectomy, which involves nerve-sparing techniques that have reduced the possibility of impotence and incontinence. He is the author of two best-selling books for lay people, "The Prostate - A Guide for Men and the Women Who Love Them," and "Dr. Patrick Walsh's Guide to Surviving Prostate Cancer," published by Warner Books in 2001.

The award will be presented at the conference during the President's Dinner on Wednesday, May 12, 2004.