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Dr. Gary Bellman, M.D.
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Does Testosterone Therapy Increase the Risk of Prostate Cancer?

Posted By: Dr. Gary Bellman on March 31, 2017

Prostate cancer begins in tissues of the prostate gland.  Located just below the bladder and in front of the rectum, the prostate is the male sex gland responsible for the production of semen.  Fortunately, prostate cancer is one of the most treatable malignancies if it's caught early and routine screening has improved the diagnosis of prostate cancer in recent years and more men are being diagnosed with early-stage prostate cancer. Prostate cancer often grows slowly, making active surveillance a treatment option for men.  In addition, new and innovative technology helps to minimize the side effects of prostate cancer treatment, including incontinence and erectile dysfunction.
 
 
High testosterone levels increase the risk of prostate cancer?
This is a hypothesis based on a very simplistic understanding of testosterone metabolism and its effect on prostate cancer.  Unlike estrogen and breast cancer, where there is a very strong relationship, testosterone and prostate cancer does not--Studies that have been published throughout the Journal of the National Cancer Institute, found no association between blood testosterone concentration and prostate cancer risk, and more recent studies have confirmed this conclusion.
 
In the most comprehensive study to date, authors found no association between risk of PCa and serum concentrations of testosterone, calculated free testosterone, dihydrotestosterone, dehydroepiandrosterone sulfate, androstenedione, androstanediol glucuronide, estradiol, or calculated free estradiol.  No combination of hormone levels was predictive of PCa.
 
Furthermore, no influence on any potential association was seen for prostate-specific antigen (PSA) level, body mass index, marital status, education, smoking, alcohol use, family history, or stage or grade of disease. The authors conclude that risk of PCa is not associated with circulating concentrations of the sex hormones.

 

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