DIHYDROTESTOSTERONE VERSUS TESTOSTERONE S ERUM VALUES IN PATIENTS WITH LARYNGEAL-CANCER AND CHRONIC LARYNGITIS

Paradoxically, the highest incidence of laryngeal carcinomas occurs in the presence of reduced gonadal androgen levels associated with agein g, while the stimulating effects of androgens on the laryngeal mucosa and their tumors have been reported in the literature. The decrease of testosterone values and nearly unchanged values of dihydrotestosteron e in serum and tissues of elderly men have been documented in recent e ndocrinological literature. This trial was performed in an effort to r esolve this apparent contradiction. Methods: Twenty-two male laryngeal cancer patients and ten patients with chronic laryngitis were examine d, and their dihydrotestosterone and total testosterone values in seru m recorded. Blood sampling was performed for each patient between 7 an d 10 a.m. before commencement of tumor therapy. An enzyme immunoassay (Serono automat SR 1) was used to determine the values of total testos terone, whereas a 5 alpha dihydrotestosterone (H 3)- radio-immune-assa y was carried out after serum extraction. Results: The total testoster one values of the laryngeal cancer patients were found to be significa ntly lower than the values in the laryngitis group, but the mean level s of dihydrotestosterone were found to be comparable within both group s. However, the scattering of dihydrotestosterone values was much high er in the group of laryngeal cancer patients than in the laryngitis gr oup. Conclusions: The average age of the cancer patients examined was 10 years higher than in the laryngitis group. The present results part ially correspond to the reports in the endocrinological literature. To gether with experimental results regarding the effects of pure substan ces of testosterone and dihydrotestosterone on permanent laryngeal can cer cell lines, the current results confirm the importance of the imba lance between testosterone and dihydrotestosterone as a cofactor in th e development of squamous cell carcinomas of the larynx. Testosterone substitution as well as blocking of 5 alpha-reductase, the enzyme whic h facilitates formation of dihydrotestosterone from testosterone, are regarded as promising therapeutic opportunities for the future, especi ally for patients with laryngeal preneoplasias or as recurrence prophy laxis after primary tumor therapy.