# Doping Linked to Testicular Cancer?



## Local Hero (Jul 8, 2010)

speculate here


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## Local Hero (Jul 8, 2010)

Ivan Basso leaves Tour de France with testicular cancer - VeloNews.com


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## Speedi Pig (Apr 18, 2004)

*Had thought of that too...hmmm*



Local Hero said:


> speculate here


Makes you wonder, but it's been almost 20 years since Armstrong was diagnosed. What's the population of top level professional cyclists who are (or were for you optimists) doping (since we're hypothesizing there is a connection) at any given time...several hundred?

Are we assuming that all PEDs increase the risk? It seems likely that the preferred (or undetectable) drugs would change over time.

I looked up the stats for the incidence of testicular cancer: 1 out of 263 males will be diagnosed at some point in their lives. The average age of diagnosis is 33 with 86% of cases occurring between the ages of 20 and 55.

What are the key statistics about testicular cancer?

Not saying there's not a connection, but I don't think two guys (that we know of) in 20 years is a smoking gun either. Compare that to the emergence of EPO when there were ~ 20 suspected deaths in a 4 year period.

Doping Part of Professional Cycling?s Culture | The Sport Digest

I'm skeptical how much of the doping problem has been reduced or eliminated either, but in fairness, even if there is a connection, in Basso's case, it could be due to his prior doping (we pretty much know he was doped to the gills ~ 2005).

Again, it initially sounds suspicious, and I wouldn't bet against it, but at this point the connection would be tenuous.


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## David Loving (Jun 13, 2008)

I believe what the Sports Digest article says about doping. Doping is part of the pro cycling culture, same as Pro Wresting. I cannot watch the Tour without realizing the doping throughout. It's best to accept that fact and enjoy the competition. I think all this hand-wringing over doping is just sideline gossip that many fans enjoy as much as the races. It is human nature to risk one's life for victory.


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## den bakker (Nov 13, 2004)

Speedi Pig said:


> Makes you wonder, but it's been almost 20 years since Armstrong was diagnosed. What's the population of top level professional cyclists who are (or were for you optimists) doping (since we're hypothesizing there is a connection) at any given time...several hundred?
> 
> Are we assuming that all PEDs increase the risk? It seems likely that the preferred (or undetectable) drugs would change over time.
> 
> ...


there have been more cyclists diagnosed in that time frame. in any case, it would be more useful for threads like this if the statistics was actually collected before sending the forum on a goose chase.


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## il sogno (Jul 15, 2002)

When Armstrong was diagnosed, the initial reaction from his doping doc was that it was caused by the dope.


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## ibericb (Oct 28, 2014)

reactions, like opinions, are often misleading.

I have not seen any reason to suspect that testicular cancer in the pro peloton is related to doping, or occurs at a higher incidence rate than in the comparable male population. Like other cancers it has been widely studied, and there are no known external risk factors that lead to an increased risk.


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## wgscott (Jul 14, 2013)

A causal connection with any cancer and environmental exposure is very difficult to demonstrate. With lung cancer, it was quite difficult, but since smoking is legal and at the time socially acceptable and very common, and lung cancer is a common cancer, the preponderance of evidence was compelling. 

Use of testosterone or other steroids is definitely suspect. I would be surprised if it didn't increase the incidence of various cancers. But establishing definitive causation is another story. In Lance Armstrong's case, it seems like a particularly idiotic thing for him to do.


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## ibericb (Oct 28, 2014)

wgscott said:


> Use of testosterone or other steroids is definitely suspect. I would be surprised if it didn't increase the incidence of various cancers. But establishing definitive causation is another story. In Lance Armstrong's case, it seems like a particularly idiotic thing for him to do.


Specifically for testicular cancer, there are no accepted or established agents that increase risk beyond those associated by race or development However, both HGH and testosterone are associated with increased incidence rates of other cancers, and EPO is associated with cancer recurrence or progression. Certainly suspicion is warranted, but nothing born out in epidemiology.


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## il sogno (Jul 15, 2002)

ibericb said:


> reactions, like opinions, are often misleading.
> 
> I have not seen any reason to suspect that testicular cancer in the pro peloton is related to doping, or occurs at a higher incidence rate than in the comparable male population. Like other cancers it has been widely studied, and there are no known external risk factors that lead to an increased risk.


That reaction tho, was from Armstrong's doping doctor who is an M.D. He was the doctor who supervised LA's doping. He knows drugs and he knows what they can do to the human body. 

I think his reaction was more legit than anything.


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## ibericb (Oct 28, 2014)

il sogno said:


> I think his reaction was more legit than anything.


I have no idea what that means. He may be the most knowledgeable MD in doping and human performance in the world, and as "legit" as you may feel his reaction to be, doesn't mean it's valid. I'd ask him to show the data to support a reasonable conclusion that there is a cause and effect relationship between what Armstrong used and testicular cancer. 

In my career I launched and sponsored a number of cancer "hot spot" investigations and studies, and I can assure you establishing meaningful causation above appropriate general population levels is not simple or trivial. As noted separately, there is certainly reason to have concern, and to suspect that there could be a relationship given the agents commonly used for doping in cycling, but nothing beyond that even now, years later.


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## den bakker (Nov 13, 2004)

il sogno said:


> That reaction tho, was from Armstrong's doping doctor who is an M.D. He was the doctor who supervised LA's doping. He knows drugs and he knows what they can do to the human body.
> 
> I think his reaction was more legit than anything.


given testicular cancer also affects men not taking doping I'm curious how he would rule out he got cancer by chance.


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## Cinelli 82220 (Dec 2, 2010)

Lance had a testicle removed so would he have had less testosterone than normal?

I've never heard of him having a TUE for hormone replacement. Just wondering, as sometimes he looked a bit more muscular than most stage racers.


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## ibericb (Oct 28, 2014)

A rational assessment, based on what's known, from City of Hope here. Specifically for testicular cancer, any association with doping practices in cycling is pure speculation. That said, there's rational reason for the hypothesis.


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## PBL450 (Apr 12, 2014)

den bakker said:


> there have been more cyclists diagnosed in that time frame. in any case, it would be more useful for threads like this if the statistics was actually collected before sending the forum on a goose chase.


How does someone "send the forum on a goose chase?" If "the forum" wants to chase a goose it can choose to, or the people posting on it can... That behavior is a choice. Anyone can post any kind of question they want. If people choose to go find the data then they chose to go find data. 

"there have been more cyclists diagnosed in that time" is a great example (you might occasionally use things like caps to begin sentences). How many cyclists? Who? "More" says what? I'm feeling the need to go on a goose chase after a post like that, but I won't because that's a choice... "If the statistics was actually collected?" Perhaps someone wants to know, from the many wise members here if they are aware of that information? Or, "if they was collected that information."


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## den bakker (Nov 13, 2004)

PBL450 said:


> How does someone "send the forum on a goose chase?" If "the forum" wants to chase a goose it can choose to, or the people posting on it can... That behavior is a choice. Anyone can post any kind of question they want. If people choose to go find the data then they chose to go find data.
> 
> "there have been more cyclists diagnosed in that time" is a great example (you might occasionally use things like caps to begin sentences). How many cyclists? Who? "More" says what? I'm feeling the need to go on a goose chase after a post like that, but I won't because that's a choice... "If the statistics was actually collected?" Perhaps someone wants to know, from the many wise members here if they are aware of that information? Or, "if they was collected that information."


I remember a few cases but don't remember the names involved. Which is enough to state it's not the only two cases in 20 years. if you don't believe me. Well tough. 
you and local can keep on speculating. Note I kept something for you to criticize while butchering punctuation yourself. 
As several other posters have pointed out, obtaining the data for it is essentially hopeless and thus this discussion is essentially moot in the first place.


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## ibericb (Oct 28, 2014)

An article out today addressing the question of a relationship with cycling broadly, citing Dr. Thomas Schwaab, an associate professor of oncology at Roswell Park Cancer Institute in Buffalo, New York, who basically suggests there is no known link.

If you want to find a link to PEDs and testicular cancer look to creatine, and possibly androstenedione.


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## honkinunit (Feb 13, 2005)

Nuts.


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## Local Hero (Jul 8, 2010)

den bakker said:


> you and local can keep on speculating.


 There has been speculation the effect of "Armstrong gave himself cancer" (not by me) but now it is out of bounds, sending the forum on a goose chase, for me to invite others to to speculate now that another doper has the same cancer?


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## PBL450 (Apr 12, 2014)

wgscott said:


> A causal connection with any cancer and environmental exposure is very difficult to demonstrate. With lung cancer, it was quite difficult, but since smoking is legal and at the time socially acceptable and very common, and lung cancer is a common cancer, the preponderance of evidence was compelling.
> 
> Use of testosterone or other steroids is definitely suspect. I would be surprised if it didn't increase the incidence of various cancers. But establishing definitive causation is another story. In Lance Armstrong's case, it seems like a particularly idiotic thing for him to do.


You bet they are hard to establish... Years ago when I was doing worker safety and health advocacy I worked on a project trying to get testicular cancer a job related illness for LEOs. Hand held radar units were very common and LEOs rested them on their laps. We tried with a host of cancers in firefighters cases... Smoldering furniture and carpet is pretty toxic stuff. But we were unsuccessful in all cases in convincing courts of causation. And our experts were every bit as good as their experts. Maybe that landscape has changed over the years, I'm not sure, but convincing folks of cause is steep climb.


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## bluelena69 (Apr 19, 2005)

Uhhh, no


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## DrSmile (Jul 22, 2006)

There is a pretty clear link between cancers and the common doping regimens (Epo, HGH) so it seems plausible that the risk of testicular cancer would also be increased. The professional doping club is probably too small to ever come up with a statistically significant test, but maybe more people will dope in the future and we'll get a chance to find out...


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## BacDoc (Aug 1, 2011)

"maybe more people will dope in the future"

Pretty sure they doped in the past, most if not all are doping right now and they all will be doping in the future.

Why? Because it works.


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## BacDoc (Aug 1, 2011)

If doping increases testicular cancer, then a shitload of male pro athletes should be getting it!


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## spade2you (May 12, 2009)

BacDoc said:


> If doping increases testicular cancer, then a shitload of male pro athletes should be getting it!


Agreed. WWF guys, Hollywood actors, and football players would have made testicular cancer as they lived to a ripe age of about 60. 

The problem with cancer is that there are many layers to it and many possible causes. There are some cancers that grow faster in response to certain hormones.


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## ibericb (Oct 28, 2014)

While there are various increased cancer risk associations with each of the well used PED's individually, none of those have been correlated with any increased risk of testicular cancer individually. However, I don't believe there are many sports that have widely used the combinations of hormones and EPO that cycling has. My concern for cycling would be combination effects of say testosterone and EPO, that I don't believe has been evaluated at all, and the pool regularly using it is probably too small to make any deductions about increased risk.


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## jaggrin (Feb 18, 2011)

On average 8,430 Americans are diagnosed with testicular cancer each year. I highly doubt they are all professional bike racers taking EPO and steroids.


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## Local Hero (Jul 8, 2010)

jaggrin said:


> On average 8,430 Americans are diagnosed with testicular cancer each year. I highly doubt they are all professional bike racers taking EPO and steroids.


Is anyone saying that?


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## ibericb (Oct 28, 2014)

jaggrin said:


> On average 8,430 Americans are diagnosed with testicular cancer each year. I highly doubt they are all professional bike racers taking EPO and steroids.


Obviusly not. What's your point?


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## jaggrin (Feb 18, 2011)

Local Hero said:


> Is anyone saying that?


The thread title is doping linked to testicular cancer which you started. In reading through the various posts many are trying to make some connection because two racers that we know of in the last 18 years who are known PED users have been diagnosed with testicular cancer.


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## ibericb (Oct 28, 2014)

jaggrin said:


> The thread title is doping linked to testicular cancer which you started. In reading through the various posts many are trying to make some connection because two racers that we know of in the last 18 years who are known PED users have been diagnosed with testicular cancer.


Others of us are stating that a such a connection has not and cannot be made, but given the common agents that we know have been used, and their known connection with increased risk for cancer, there is good reason to suspect that there could be a relationship between select PDE use and an increased incidence rate of testicular cancer. That reasoning is purely hypothetical and speculative.


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## jaggrin (Feb 18, 2011)

ibericb said:


> Others of us are stating that a such a connection has not and cannot be made, but given the common agents that we know have been used, and their known connection with increased risk for cancer, there is good reason to suspect that there could be a relationship between select PDE use and an increased incidence rate of testicular cancer. That reasoning is purely hypothetical and speculative.


Maybe you should stop speculating on something you know absolutely nothing about.

Factors that increase the risk of getting testicular cancer include:

Having had an undescended testicle (also called cryptorchidism): Most cancers start in the testicle that did not move down on its own, but about 1 out of 4 occurs in the normal testicle.
Family history (having a close relative with testicular cancer)
HIV infection
CIS (carcinoma in situ) (described in “What is testicular cancer?”)
Cancer in the other testicle
Age: About half of testicular cancers occur in men between the ages of 20 and 34.
Race/ethnicity: In the US, white men are more likely to get testicular cancer than other groups.
Body size: Tall men may have a higher risk of testicular canc


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## jaggrin (Feb 18, 2011)

ibericb said:


> Others of us are stating that a such a connection has not and cannot be made, but given the common agents that we know have been used, and their known connection with increased risk for cancer, there is good reason to suspect that there could be a relationship between select PDE use and an increased incidence rate of testicular cancer. That reasoning is purely hypothetical and speculative.


With all of those key facts unknown, I asked Dr. Philip Kantoff, Chief of the Division of Solid Tumor Oncology at Dana-Farber Cancer Institute in Boston, whether there could possibly be any link between taking performance-enhancing drugs and developing testicular cancer. Of course Dr. Kantoff has no personal knowledge of Armstrong’s history and our conversation was purely speculative. Here, slightly edited is what he said:

“There are no studies that prospectively look at testicular cancer with any of these drugs…Theoretically, of the drugs under consideration — I’m not sure he took human growth hormone — but of the potential performance enhancing drugs he may have taken, it’s conceivable that growth hormone could, theoretically, be linked to cancer but there is no study to support that…

[On the question of testosterone, Dr. Kantoff said the most common context for treatment with testosterone is this]…the guy that comes in, he’s a middle-aged man, a little depressed, his libido is down and his testosterone is slightly low. They give him enough to normalize his testosterone levels, but this is not in the category of enhancing, it’s normalizing levels. And again, there aren’t any definitive studies on this…there’s belief and then there are studies…

With performance enhancement, you take people with normal levels and gve them super high levels. It’s a whole understudied field. Nobody’s ever taken a look at 20-to-30-year-olds with normal testosterone levels and giving them super high levels and the side effects from that…

With human growth hormone, it’s conceivable — you can enhance the growth of cells — but there’s no data.”

About 5,000-10,000 men a year develop testicular cancer, Kantoff said. But it’s the most common cancer in men between 20 and 40 in the U.S. So what’s the bottom line in Armstrong’s case?

“Any conclusion that there’s a link would be a big leap here,” Kantoff said. “All of these things could cause harm when taken at super high levels, but nobody’s ever studied it.”


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## ibericb (Oct 28, 2014)

jaggrin said:


> Maybe you should stop speculating on something you know absolutely nothing about.


Maybe you should read the thread, and the references cited in prior posts. All of that has been previously pointed to.


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## CBus660R (Sep 9, 2011)

jaggrin said:


> but nobody’s ever studied it.”


These are the key words on why people speculate. Just as there is no study saying there is a link, there is also a lack of a study to say there is no link. That is why speculation exists.


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## ibericb (Oct 28, 2014)

Prexactly. It's not known.


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## Local Hero (Jul 8, 2010)

I don't really care what Dr. Kantoff says. Our very own Doctor Falsetti said that epo causes cancer.


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## Handbrake (May 29, 2012)

il sogno said:


> When Armstrong was diagnosed, the initial reaction from his doping doc was that it was caused by the dope.


That is 100% not true.


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## ibericb (Oct 28, 2014)

Handbrake said:


> That is 100% not true.


Michele ... Michele Ferrari ... is that you?


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