© 2010 Wichtig Editore - ISSN 0391-5603 Urologia ( 2010 ; : 2) 92-99 77 92 ARTICLE TYPE UROLOGIA E SPORT INTRODUZIONE Diverse sostanze quali stimolanti, agenti anabolizzanti, narcotici e peptidi ormonali vengo utilizzate in manie- ra impropria da diversi atleti professionisti e non con lo scopo di migliorare la performance atletica andando ad agire sulla resistenza alla attività fisica e la massa mu- scolare. Negli ultimi anni queste sostanze sono state uti- lizzate anche da non atleti e da adolescenti con il fine di combattere l’età, l’obesità e migliorare l’aspetto esteriore dietro la spinta dei media e degli interessi economici che inducono ad eccellere nello sport e nella vita a tutti i co- sti (1-3). Per dare un’idea delle dimensioni del problema basta pensare che, ad una stima del 2001, 1-3 milioni di atleti solo negli Stati Uniti avevano utilizzato sostanze anabolizzanti con un mercato nero annuo di 110 milioni Doping e neoplasie urologiche F. Pinto, E. Sacco, A. Volpe, M. Gardi, A. Totaro, A. Calarco, M. Racioppi, G. Gulino, A. D’Addessi, P.F. Bassi Clinica Urologica, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma Doping and urologic tumors Several substances such as growth hormone (GH), erythropoietin (Epo), and anabolic steroids (AS) are improperly utilized to increase the performance of athletes. Evaluating the potential cancer risk associated with doping agents is difficult since these drugs are often used at very high doses and in combination with other licit or illicit drugs. The GH, via its mediator, the insulin-like growth factor 1 (IGF-1), is involved in the development and progression of cancer. Animal studies suggested that high levels of GH/IGF-1 increase progression of androgen-independent prostate cancer. Clinical data regarding prostate cancer are mostly based on epidemiological studies or indirect data such as IGF-1 high levels in patients with prostate cancer. Even if experimental studies showed a correlation between Epo and cancer, no clinical data are cur- rently available on cancer development related to Epo as a doping agent. Androgens are involved in prostate carcinogenesis modulating genes that regulate cell proliferation, apoptosis and angiogen- esis. Most information on AS is anecdotal (case reports on prostate, kidney and testicular cancers). Prospective epidemiologic studies failed to support the hypothesis that circulating androgens are positively associated with prostate cancer risk. Currently, clinical and epidemiological studies supporting association between doping and urologi- cal neoplasias are not available. Nowadays, exposure to doping agents starts more prematurely with a consequent longer exposition period; drugs are often used at very high doses and in combination with other licit or illicit drugs. Due to all these elements it is impossible to predict all the side effects, including cancer; more detailed studies are therefore necessary. KEY WORDS: Doping, Cancer, Growth hormone, Insuline-like growth factor-1, Erythropoietin, Androgen receptor, Anabolic steroids PAROLE CHIAVE: Doping, Cancro, Ormone della crescita, Insuline-like growth factor-1, Eritropoietina, Recettore androgenico, Steroidi anabolizzanti Doping.indd 92 7-10-2010 12:49:09