A recent study has found that high doses of a widely-used hormonal treatment can increase the risk of meningioma, a common brain tumor.
Meningioma is a slow-growing benign brain tumor that arises from the membranes surrounding the brain and spinal cord. Although meningiomas are one of the most common tumors of the brain, they are not easy to diagnose. Mostly, doctors discover the tumor incidentally, either on imaging or during autopsies. Most cases never present with any symptoms; however, some tumors can grow large enough to compress neighboring nerves and vessels. While the exact cause of meningiomas is unclear, genetic mutations and environmental factors increase the risk of occurrence. Moreover, multiple researchers have linked hormone treatments, particularly cyproterone acetate (CPA), to the tumor.
What is CPA?
Cyproterone Acetate is an anti-androgen and progestin medication commonly known by its brand name – Diane or Diane-35. Generally, doctors administer the hormonal treatment for treating a wide variety of conditions such as early puberty, excessive hair growth, and prostate cancer. Moreover, the drug is a component of birth control pills. High doses of the drug are also used for male-to-female transsexual hormonal therapy.
As a result of the CPA’s widespread use, researchers at the Universities of Bristol, Cambridge, and the National University of Singapore conducted a systematic review and meta-analysis to assess the link between CPA and the incidence of meningiomas. The team outlined their findings in the journal Scientific Reports.
The analysis included four studies comprising more than 8 million patients. Researchers identified a total of 165,988 patients who took cyproterone acetate at varying doses. Next, the team assessed the occurrence of the brain tumor among the patients using high and low doses of the drug. Results revealed a significantly increased risk of meningiomas with high dose usage. However, the study authors did not find a link between low doses and the brain tumor.
Therefore, study authors call for routine screening and meningioma surveillance by brain MRI of patients using CPA.
Keng Siang Lee et al, A systematic review and meta-analysis of the association between cyproterone acetate and intracranial meningiomas, Scientific Reports (2022). DOI: 10.1038/s41598-022-05773-z