There’s been a lot of discussion recently concerning the link between testosterone in males and the progression of prostate cancer. For many years we have associated prostate cancer with high levels of testosterone but recent studies suggest the opposite. Testosterone is produced by the testes. Men need it for sexual function and like all hormones produced by the body; it contributes to a feeling of health and general well-being.
The testes need the help of the prostate gland to produce this testosterone. The prostate, a gland that is wrapped around the bladder, secretes prostate fluid which helps to nourish and transport sperm.
Prostate cancer is not caused by high testosterone levels but once developed the cancer uses testosterone to help it grow. Lower testosterone levels can help an advanced tumor from growing larger, in some cases it can even help shrink it. It’s also thought that if you are in the early stages of prostate cancer, lowering testosterone levels can reduce your chances of a relapse in later years. For this reason, most patients will be given hormone depletion medication by their doctor soon after diagnoses. If you are deliberately lowering your testosterone to shrink an advanced tumor then it’s worth noting that it can be successful for a few years but after that the tumor becomes immune to the lack of testosterone and can start re-growing.
Living with low testosterone lowers the quality of life as it affects sexual function as well as muscle mass, mood and motivation. For these reasons many men with low testosterone levels, whether it be naturally or medically induced, seek to increase their testosterone. During treatment you should not seek to increase testosterone but many doctors also discourage remission patients from taking extra testosterone. They feel it can fuel cancer cell re-growth and a return of the cancer. This has been the school of thought for many years but doctors like Dr Morgentaler from the Harvard Medical School started seeking other explanations”why do men develop prostate cancer when they are older, at the same time their testosterone levels are dropping?” he has a point, surely if larger amounts of testosterone feed prostate cancer then why do older men with lower testosterone levels get it? Surely it should be more prevalent in younger men who have high testosterone levels?
Following on from this, recent studies have found that there is a strong connection between men with low testosterone and early prostate cancer progression. This shows the opposite to what many doctors have said in the past.
Dr Ignacio San Francisco, MD, of the Pontificia Universidad CatÃ³lica de Chile, conducted one such study on 154 men at surveillance level early stage prostate cancer and it was published in BJU International. They broke down the research into 2 classifications, free testosterone and total testosterone. Free testosterone refers to the amount of testosterone found in the blood stream that is not bound to other chemicals, it accounts for up to 4% of the testosterone. Total testosterone refers to all the testosterone found in the blood stream, whether it is chemically bound or not. Interestingly enough, the study found little connection between total testosterone and the advancement of prostate cancer but they did find significant associations with low levels for free testosterone. The conclusion was that men with low levels of free testosterone had an increased risk of the cancer advancing aggressively.
Dr San Francisco explains how helpful this study is for doctors and their patients when undergoing risk evaluation. “In borderline cases, the presence of low values of free testosterone may help determine whether it is more prudent to initiate treatment rather than continue observation”.
Many doctors still feel that you should not take testosterone replacement therapy if have prostate cancer or have suffered from it in the past, even if was treated in the early stages of cancer. However times are changing and as more studies surface showing contradictory advice, more doctors are weighing up the risks more. If early stage prostate cancer survivors have little chance of the cancer re-growing due to testosterone replacement therapy, then there is no reason to restore levels to normal functionality. It also allows doctors to delay treating early stage patients with hormone depletion medication which is normally the first step to controlling the disease.
To understand more about testosterone, feel free to download this free testosterone information booklet.