Can Testosterone Protect Against High-Grade Prostate Cancer?

[CoastWatcher]

Yet another examination of the possible link between prostate cancer and testosterone showing that TRT is not the demon many - including far too many doctors - believe it to be.

• This study investigated the role of testosterone replacement therapy (TRT) in prostate safety and cancer progression.
• A cohort of 553 patients hypogonadal men, 42 treated and 162 untreated, and 349 eugonadal men were included.
• Pathological analysis of prostate biopsies examining the incidence and severity of PCa revealed that: 16.7% of treated hypogonadal men had a positive biopsy, a Gleason score of ≤6 in 71.4% and >6 in 28.6% of men, a predominant score of 3 and tumour staging of II in 85.7% men; 51.9% of untreated hypogonadal men had a positive biopsy, a Gleason score of ≤6 in 40.5% and >6 in 59.5% men, a predominant score of 3 (77.4%) and tumour staging of II (41.7%) or III (40.5%);
• 37.8% of eugonadal men had a positive biopsy, a Gleason score of ≤6 in 42.4% and >6 in 57.6% of men, a predominant score of 3 (82.6%) and tumour staging of II (44.7%) or III (47.7%).
• The incidence of positive prostate biopsies was lowest in hypogonadal men receiving TRT, with significantly lower severity of PCa in terms of staging and grading in the same group. These results suggest that TRT might have a protective effect against high-grade PCa.

"Is there a protective role of testosterone against high-grade prostate cancer? Incidence and severity of prostate cancer in 553 patients who underwent prostate biopsy: a prospective data register," Aging Male, 2017 June, https://www.ncbi.nlm.nih.gov/pubmed/28282997/

 

[Pauly_P]

Recently Jay Campbell had a guest on his podcast, Dr. Nick Sakkas, who is challenging the belief that TRT is contraindicated for prostrate cancer. Interesting podcast. I'm somewhat surprised that there is not more discussion on this forum regarding PC since 1 in 7 men get it.

 

[CoastWatcher]

Recently Jay Campbell had a guest on his podcast, Dr. Nick Sakkas, who is challenging the belief that TRT is contraindicated for prostrate cancer. Interesting podcast. I'm somewhat surprised that there is not more discussion on this forum regarding PC since 1 in 7 men get it.

There are multiple threads on the possible relationship between prostate cancer and exogenous testosterone, including many of the mist recent research reports/studies on the topic. Many - if not most - are Sticky.

 

[Vince]

There are multiple threads on the possible relationship between prostate cancer and exogenous testosterone, including many of the mist recent research reports/studies on the topic. Many - if not most - are Sticky.

Yes it's a very well debated question. I believe something like 85% of all men will get prostate cancer, you live long enough. So I guess enjoy your prostrate as long as you can.

 

[Pauly_P]

There are multiple threads on the possible relationship between prostate cancer and exogenous testosterone, including many of the mist recent research reports/studies on the topic. Many - if not most - are Sticky.

Thanks CoastWatcher, I'll look a bit harder. Take a listen to that podcast I referenced, the discussion starts around the 20 minute mark.

 

[Jed Dorsey]

@Neslon Virgil I am 51 and was on TRT for 1 and half years. I was later diagnosed with PCa Gleason 6. It is a very perplexing question if it was caused by my age, testosterone or estrogen or a combination of all three. I dont have PCa in my family history and while on TRT my test level was around 700 also my doctor didn't prescribe me an AI so my estrodail was out of range.
I would like to believe that TRT is good for us because while on TRT I've never felt better since my 30's.
With all of the studies suggesting that Testosterone helps in keeping PCa from progressing I struggle with the question why are Oncologist still prescribe Lupron to reduce endogenous testosterone to cancer patients?

 

[Nelson Vergel]

Hi Jed

Excellent question! I asked Dr. Mohit Khera, one of the top experts on the subject ( see my interview with him below) and this is what he said:

"For decades we believed that testosterone was dangerous. The paradigm started to change in the 2000s when we started to believe that testosterone may be actually safe in men with a history of prostate cancer. In 2015 studies started to emerge regarding the therapeutic potential of testosterone in men with advanced prostate cancer. For example, studies from Johns Hopkins used high doses of testosterone to treat men with metastatic prostate cancer. In one of these studies, men with metastatic prostate cancer had a 50% reduction in their PSA and 50% reduction in visible metastatic disease on imaging after initiating high doses of testosterone. Finally, we are getting into an era where many believe that testosterone may be protective against the recurrence of prostate cancer. Several studies have found that those men being treated with testosterone have a lower rate of biochemical recurrence after prostate cancer surgery. It is important to realize that despite these studies, we still do not have any randomized placebo-controlled trials assessing the safety of testosterone in men with a history of prostate cancer. Thus, the recent 2018 AUA Testosterone Guidelines state that men who are being treated with testosterone after prostate cancer surgery should be told that currently there is inconclusive evidence to support the safety of testosterone in these men. Clearly, more research needs to be done in this field."

 

[Nelson Vergel]

Circulating preoperative testosterone level predicts unfavourable disease at radical prostatectomy in men with International Society of Urological Pathology Grade Group 1 prostate cancer diagnosed with systematic biopsies - World Journal of Urology

Purpose The association between circulating total testosterone (T) levels and clinically significant PCa is still a matter of debate. In this study, we evaluated whether serum testosterone levels may have a role in predicting unfavorable disease (UD) and biochemical recurrence (BCR) in patients...

link.springer.com