Can Steroids Cause Breast Cancer

How Can Weight Gain From Fluid Retention Be Managed

Fluid retention or edema is swelling caused by the buildup of fluid in the body. If you have edema, you might feel like your clothes, rings, or shoes are too tight. People with edema can also have less flexibility in their hands, elbows, wrists, fingers, or legs. Swollen arms or legs, especially around the wrists or ankles, are also a sign of edema. The fluid buildup collects under the skin, so your skin might feel puffy or stiff. Pressing on your skin might leave small indentations.

Talk to your health care team about any of these symptoms so they can diagnose and treat edema. Some of the ways edema can be managed include:

• Medication. Your doctor can prescribe a diuretic to remove excess water.

• Lower the amount of salt in your diet.

• Avoid standing for long periods.

• Elevate your feet as often as possible.

• Avoid crossing your legs, which restricts blood flow.

• Weigh yourself at the same time every day to keep track of changes. This can help your health care team see any fluctuations in your weight that might be caused by edema. Bring this log with you to appointments for your health care team to evaluate.

• Avoid tight clothing and footwear.

• Ask your health care team if wearing support or compression socks may help.

Just How People Use Steroids For Bodybuilding

Seeking for means to raise the speed as well as high quality of bodily stamina as well as activities has been a tendency for centuries. These means include taking medications. Doping in sporting activities is referred to willful or unintentional use of medications which falsely raise the power and also stamina of the competitioners as well as is thought about a prohibited and also unethical act.

Anabolic steroids have been used by athletes and also non athletes for past four decades. In sporting activities as well as bodybuilding, it is utilized to enhance strength or physique. The tendency to utilize anabolic steroids has been seen in different age from teenagers to adults.

Various studies reveal that restorative doses of anabolic steroids have no result on muscle toughness and professional athletes performance, but the bodybuilders utilize 10 to 50 times of healing dosages.

Gynaecomastia And Anabolic Steroid Use

Whilst Niewoehner and Schorer note in their review of gynaecomastiaandbreast cancer in men that the use of anabolic steroids should beconsideredin the cause of gynecomastia , it is important to recognise thesignificantlevels of use of these drugs for performance- and image-enhancing reasonswithin the general population . Furthermore, many users practicecomplex, self-directed, polydrug regimes that include not onlytheuse of supraphysiologic doses of multiple types of anabolic steroids butalso,inter alia, growth hormone, human chorionic gonadotropin, spironolactoneand a wide variety of supplements ) substances that have allbeen

Given the high levels of self-reported gynecomastia in users andreflected in the widespread prophylactic use of self-prescribed tamoxifen, weconsider it particularly relevant to ask about use of anabolic steroidsandancillary substances inindividualspresenting with gynecomastia who have mesomorphic or hypermesomorphicbody types .

As the authors of the review highlight, however, patients can feelembarrassed and anxious by their condition and this can be compounded inthis population given the demonisation of anabolic steroids by society.Further, the historic low-level of engagement and trust by this population

with health professionals may act on this, which could increase areluctance to reveal their use of these substances . Alongside this,

1. Niewoehner CB, Schorer AE. Gynaecomastia and breast cancer in men.BMJ.

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Understanding Cortisol And The Stress Response

In order to understand how steroids may be used for people with cancer, it’s helpful to consider how “natural” steroids function in the body and the importance of using these medications only as directed.

When our bodies are stressedwhether physically or emotionallya signal is sent to the pituitary gland, a small endocrine gland in the brain. The pituitary gland sends out a hormone called adrenocorticotropic hormone . ACTH, in turn, instructs the adrenal glands to release cortisol, a “natural steroid.”

Cortisol plays an important part in managing the stress, through altering inflammation, responding to infection, and a host of other functions. ranging from the control of blood pressure to the control of blood sugar.

Pharmaceutically produced synthetic steroids function much like cortisol. These powerful medications have many uses in medicine and are a key component in the treatment of blood-related cancers, such as leukemia, lymphoma, and myeloma, as well as solid cancers.

Increased Risk Of Leukemia

Very rarely, certain chemo drugs, such as doxorubicin , can cause diseases of the bone marrow, such as myelodysplastic syndromes or even acute myeloid leukemia, a cancer of white blood cells. If this happens, it is usually within 10 years after treatment. For most women, the benefits of chemo in helping prevent breast cancer from coming back or in extending life are far likely to exceed the risk of this rare but serious complication.

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Steroids Increase Skin Cancer Risk

Increase in Skin Malignancies, Lymphoma Seen in Study

May 4, 2004 – Millions of people who take immune system-suppressing steroids like prednisone to treat a wide range of inflammatory diseases may be at increased risk for developing certain cancers. New research supports earlier reports linking steroid use to nonmelanoma-type skin malignancies and non-Hodgkin’s lymphoma.

The risk of developing non-Hodgkin’s lymphoma or a form of skin cancer called squamous cell carcinoma was roughly two-and-a-half times greater than normal for people who reported long-term use of steroids in the Danish study. Long-term steroid use was associated with a 50% increased risk for developing basal cell carcinoma.

“We have known that immunosuppressive therapy increases the risk for these cancers in transplant recipients, but these patients are treated with other, more potent immune system-suppressing drugs,” lead researcher Henrik Toft Sorensen, MD, PhD, tells WebMD. “The risk associated with use alone has not been clear.”

Key Points About Gynecomastia

• Gynecomastia is an overdevelopment or enlargement of the breast tissue in men or boys.
• The breasts become larger. They often grow unevenly.
• It is often caused by changes in levels of the female hormone and the male hormone . Other things may cause it as well.
• Most cases happen when a preteen or teenage boy is going through puberty. But it can also happen to newborn babies and older men.
• It often goes away on its own. In some cases, hormone therapy is needed. Surgery may also help treat the condition.

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How Is Gynecomastia Treated

Your healthcare provider will figure out the best treatment for you based on:

• How old you are
• Your overall health and past health
• How sick you are
• How well you handle certain medicines, treatments, or therapies
• How long the condition is expected to last
• Your opinion or preference

Most cases of gynecomastia happen during puberty. The condition usually gets better on its own without treatment. This may take from 6 months to 2 or 3 years.

If a medicine is causing your breast enlargement, you may need to stop taking the medicine. That can solve the problem. If a disease is causing the condition, the disease will need to be treated.

Hormone therapy may be used to treat gynecomastia.

In rare cases, surgery may be used to remove the extra tissue.

What Are The Hormone Sources In Men

Testicular Leydig cells produce 95% of testosterone. The adrenal cortex produces the rest. About 50% of circulating testosterone is bound to sex hormone binding globulin. Much of the remainder is weakly bound to albumin. Only the free hormone is active. Oestrogen is less bound to sex hormone binding globulin than testosterone, so increases in sex hormone binding globulin reduce the ratio of active testosterone to oestrogen.

Testosterone can be converted to another potent androgen, dihydrotestosterone, by the enzyme 5 reductase in peripheral tissues. Testosterone also can be converted to oestradiol by the enzyme aromatase, found especially in adipose tissue. The weak adrenal androgen androstenedione can be converted by aromatase to oestrone, a weak oestrogen. Oestradiol and oestrone can be interconverted in peripheral tissues .

Fig 1Sources of hormones affecting breast tissue

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Medical And Dental Treatment

If you need medical treatment for any reason other than cancer, always tell the doctors and nurses you are having cancer treatment. Give them the contact details for your cancer doctor so they can ask for advice.

If you think you need dental treatment, talk to your cancer doctor or nurse. Always tell your dentist you are having cancer treatment.

How Can Weight Gain During Cancer Treatment Be Managed

If you notice changes in your weight, eating habits, or bloating, let your health care team know so they can help you. Relieving symptoms and side effects is an important part of your overall cancer care and treatment. This type of care is called palliative care or supportive care.

Before starting any kind of diet or changing your eating habits, talk with a member of your health care team. You may find it helpful to talk with a registered dietitian . They will help you find the possible cause for your weight gain and the best way to manage it. An RD can also provide nutritional guidelines or a customized diet plan.

General suggestions about good nutrition during cancer treatment include:

• Eat plenty of fruits, vegetables, and whole grains.

• Limit fat, sugar, and refined flour.

• Drink plenty of water.

• Use healthier cooking methods whenever possible.

Regular physical activity can also be helpful during and after cancer treatment. Check with your doctor before starting a new type of exercise or increasing your physical activity.

• Try different physical activities, such as walking or bicycling, to find one that you enjoy and will do regularly.

• Explore exercise classes designed for people diagnosed with cancer, either in-person or online.

• Try strength-building exercises. These can be especially helpful if you have lost muscle.

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Avoiding And Managing Lymphedema

If you’ve been diagnosed with lymphedema, there are treatments to reduce the swelling, keep it from getting worse, and reduce the risk of infection.

Lymphedema can be treated by a physical therapist or other healthcare professional who has special training. A lymphedema specialist is trained in techniques that can help reduce swelling and increase strength and flexibility. Your specialist should be able to create a program for you that includes massage of the affected area, physical therapy exercises, skin care, and if necessary, compression bandages and fitted sleeves. Check with your insurance company to make sure your lymphedema treatment is covered.

Reduce swelling after surgery. Right after surgery, the arm or breast area involved may swell. The swelling is usually temporary and usually goes away over the next 6 to 12 weeks. To help ease this swelling:

Try to avoid infection and burns. If you have an infection or burn, your body makes extra fluid to fight it. If you’ve had lymph nodes removed, it can be harder for your body to transport this extra fluid and this can cause lymphedema. Taking good care of your skin and practicing good hygiene can help reduce your risk of lymphedema by avoiding infection or a burn.

Try to avoid squeezing your arm. This can increase the pressure in nearby blood vessels, which can lead to swelling. Lymphedema also has been associated with air travel, possibly because of low cabin pressure.

Other tips to help avoid lymphema:

Changes In Blood Sugar Levels

You might have regular blood and urine tests to check this. Some people develop diabetes. You might need to have blood sugar lowering treatment. But your sugar levels usually go back to normal shortly after you stop taking steroids.

If you have diabetes already, you might need to check your blood sugar levels more often than usual.

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Mood And Behaviour Changes

Steroids can affect your mood and behaviour. They can cause:

• feelings of anxiety or restlessness
• mood swings
• low mood or depression.

Sometimes, when taken in higher doses, steroids can cause confusion or changes in thinking. This can include having strange or frightening thoughts.

Tell your doctor or nurse if you notice any changes in your mood or behaviour. They may make some changes to your treatment if the side effects are causing you problems.

Redirection Of Er Function By Transcription Factors Downstream From Hormone And Cytokine Signaling

It has been demonstrated in breast cancer patient samples that differential binding profiles for ER are associated with clinical outcome . It has been hypothesized that the differential ER genomic binding patterns dictate activation of distinct target genes that are associated with treatment response. This highlights the functional importance of ERchromatin interactions for tumor progression and the need for delineating the factors and pathways that influence ER binding to chromatin.

ER functions as part of a large transcriptional complex involving multiple transcription factors, including its pioneer factor, FOXA1 , as well as other cooperating factors e.g., PBX1 , the transcription factor AP-2 , and GATA-binding protein 3 . Many of these modulate the activity of the ER pathway by directly affecting binding of ER to chromatin e.g., by modulating the local accessibility of the chromatin, as has been suggested for FOXA1 and PBX1 .

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Chemo Drugs For Breast Cancer That Has Spread

• Taxanes: Paclitaxel , docetaxel , and albumin-bound paclitaxel
• Ixabepilone
• Gemcitabine
• Antibody drug conjugates

Although drug combinations are often used to treat early breast cancer, advanced breast cancer often is treated with single chemo drugs. Still, some combinations, such as paclitaxel plus gemcitabine, are commonly used to treat metastatic breast cancer.

For cancers that are HER2-positive, one or more drugs that target HER2 may be used with chemo.

Associations By Attained Age During Follow

shows the associations between breast cancer risk and the levels of circulating hormones by attained age during follow-up. For both estrogens and androgens, the strongest associations with risk were observed at older ages, although the test for heterogeneity across age groups was statistically significant only for androgens: the breast cancer HRs associated with a doubling of hormone concentration for women of ages < 65 years, between 65 and 69 years, and > 69 years were 0.92 , 0.83 , and 1.70 for testosterone 1.05 , 0.79 , and 1.74 for DHEAS and 1.03 , 0.92 , and 1.91 for androstenedione .

HRs and 95% CIs of breast cancer for a doubling of hormone concentration by attained age during follow-up

Similar trends by attained age during follow-up were obtained when the analysis was restricted to ER+ tumors, to PR+ tumors, or to ER+/PR+ tumors or when past HRT users were excluded from the analysis .

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Do Anabolic Steroids Cause Cancer

I have read anabolic steroids cause cancer!Is this true?Which cancers do they cause and what anabolic steroids cause them?

Why Are Steroids Used In Cancer Treatment

There are a number of reasons you might have steroids as part of your cancer treatment.

They can:

• reduce your bodys immune response, for example after a bone marrow transplant
• help reduce sickness when having chemotherapy
• improve your appetite

• when you are first diagnosed
• before and after surgery
• before, during and after chemotherapy treatment
• for an advanced cancer

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Diseases Associated With Gynaecomastia

Low androgen levels

• Hypogonadotrophic hypogonadism high prolactin states pituitary disease primary hypogonadisminfection , trauma, infiltration , chemotherapy, neurological disease Klinefelters syndrome true hermaphrodism congenital defects in testosterone synthesis

High androgen and high oestrogen levels

• Testicular feminisation, Leydig cell tumour, human chorionic gonadotrophin producing tumour, congenital adrenal hyperplasia

High oestrogen levels

• Abnormal aromatase , tumour aromatase, feminising adrenal carcinoma, Sertoli cell tumour, starvation and refeeding

High sex hormone binding globulin levels leading to low free testosterone levels

• High oestrogen states, genetic high sex hormone binding globulin level, hyperthyroidism

Other or multifactorial

Low androgen levels: inhibition of testosterone synthesis

• Ketoconazole metronidazole gonadotrophin releasing hormone agonists and antagonists spironolactone chemotherapy

Low androgen levels: inhibition of testosterone action

• Androgen receptor blockersbicalutamide, flutamide, nilutamide, spironolactone, eplerinone, cyproterone 5 reductase inhibitorsfinasteride, dutasteride H2 blockers and proton pump inhibitorscimetidine, ranitidine, proton pump inhibitors marijuana

High androgen levels resulting in high oestrogen levels

• Androgen administrationexcessive testosterone replacement, anabolic steroids, androgen containing contraceptives human chorionic gonadotrophin

High oestrogen levels or oestrogen action

What Causes Gynecomastia

Gynecomastia is usually a benign condition. It may be linked to many different causes of hormone changes. In many cases, the cause isnt known.

Gynecomastia is often caused by changes in levels of the female hormone and the male hormone . But it can be caused by other things as well.

Gynecomastia can be a side effect of certain medicines, such as antidepressants, antibiotics, chemotherapy, prostate cancer medicines, ulcer or cardiovascular medicines. Illegal drugs, such as anabolic steroids, heroin, or marijuana can also cause gynecomastia.

Some diseases and medical conditions may also cause gynecomastia. These include:

• Liver diseases
• Injury or trauma
• Obesity

Newborn babies may have a short-term form of gynecomastia. This is often because a mothers estrogen stays in a babys blood for a while after birth.

Gynecomastia is not linked to breast cancer. It is rare that men get breast cancer. But your provider may do some tests to rule out breast cancer.

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