Gynecomastia (OT)

[Guest guest]

Dave,

You wrote, " ..a lump that appeared two months ago in my left breast. It was

diagnosed as gynecomastia. This can be caused by reaction to a medicine, by

cirrhosis of the liver, or by

cancer. .. He noticed spider web veins on my chest and said these were also

a sign of cirrhosis. Question: can cirrhosis develop from chronic

pancreatitis? I'm wondering if the vinegar and some other liquid sauce

ingredients used

in Japanese cooking might contain the alcohol elements that destroy the

liver. "

First of all it is great to hear from you. You bring up a topic that is not

discussed very much. I am not sure why, but many people are embarrassed to

talk about it and others simply do not know anything about it, so I am glad

that you shared this with us. My understanding of gynecomastia is that it is a

benign enlargement of the male breast resulting from a growth of the glandular

component of the breast from an altered estrogen-androgen balance. It occurs

in approximately 57% of men older than 50 years.

You mentioned that gynecomastia can be caused by reaction to a medicine, by

cirrhosis of the liver, or by cancer. I wanted to also mention that this can

occur from either a decrease in testosterone or an increase in estrogen. The

other is the famous, idiopathic.

Conditions that result decreased production and/or action of testosterone

include:

* Testicular trauma

* Testicular torsion

* Viral orchitis

* Pituitary tumors

* Renal failure

Conditions that result in Increased production and/or action of estrogen

are:

· Testicular tumors or cancer of the lung, kidney, or GI tract.

· chronic liver disease, malnutrition, hyperthyroidism, or a family

history of gynecomastia

The medications implicated in gynecomastia are:

* Drugs with estrogen like digitalis,

* Drugs that enhance estrogen synthesis such as Dilantin (phenytoin)

* Drugs that inhibit testosterone synthesis or action such as

antifungals (ketoconazol), anticancer medications, diuretic (spironolactone),

antiulcer medication (cimetidine), anti-BPH (finasteride).

* Drugs that act by unknown mechanisms such as tricyclic

antidepressants, Valium (diazepam), calcium channel blockers, ACE inhibitors,

I was curious what treatment your doctor discussed. I have heard that

Tamoxifen, an estrogen antagonist, is effective.

As far as your actual questions Can cirrhosis develop from chronic

pancreatitis? The only relationship known at this time is if alcohol was the

cause of

the pancreatitis and alcohol consumption continued, then there is a chance

that you could develop cirrhosis. The research seems to be, however, that they

do not know why some develop pancreatitis and others develop cirrhosis.

There is actually very few known cases where both occur.

You were right to ask about the use of alcohol in Japanese cooking. Many of

these sauces and dishes do contain alcohol. I know that there are even many

brands of tofu that have alcohol in them. The theory of a mutation in the

'alcoholic' gene states that it may take very little alcohol to activate this

mutation, whereas previously it was thought that excessive consumption was

required.

Karyn E. , RN

Executive Director, PAI

Indianapolis, Indiana