Examination of pituitary-adrenal axis
As explained in the physiology section, the pituitary releases ACTH to stimulate the adrenal cortex to produce cortisol. To a much more limited extent, the ACTH also stimulates aldosterone and androgen production. Therefore one would expect that in gradual suppression of the pituitary-adrenal axis with dexamethasone (a glucocorticoid - see physiology section and section on Cushing's syndrome), the cortisol levels would drop first, and then the androgen levels. In the presence of an AST which is still responsive to pituitary ACTH, . a benign adrenal tumour, this suppression of the already elevated levels should be slight but still there. In the case of an AST which is autonomous having lost its sensitivity to pituitary ACTH, . a malignant tumour, there should be no suppression at all.
Coffee drinking has been associated with a decreased risk of symptomatic gallstones, according to research conducted by the Harvard School of Public Health and published in the June 9, 1999, issue of the Journal of the American Medical Association . The study found that men (over 46,000 men were studied) who drank two or three cups of coffee a day had a 40 percent lower risk of developing gallstones, while men who drank 4 or more cups of coffee a day decreased their risk by 45 percent. The study found no relation between gallstone prevention and tea, decaffeinated coffee, or caffeinated soft drinks.
Gynecomastia is a common adverse effect of bicalutamide (Casodex) therapy that may prompt some men to discontinue prostate cancer treatment. Tamoxifen has been recommended as a preventive agent for gynecomastia in these patients. A double-blind study of 282 men randomized to receive 20 mg of tamoxifen once per day with bicalutamide or bicalutamide alone found that after six months, gynecomastia and breast pain were significantly reduced in men who received tamoxifen ( versus percent in the control group). 41 An Italian randomized controlled trial of 80 participants also found that 20 mg of tamoxifen once per week is as effective as 20 mg once per day. 42