Hormonal changes after localized PCa treatment.

[pjoshea13]

Fascinating new study from Spain [1].

Brought to mind a 1998 Patrick Walsh study (Johns Hopkins) [2]. Hormone levels were measured before surgery & one year after surgery:

"... there was a statistically significant increase in serum testosterone, free testosterone, estradiol, LH and FSH .., and statistically significant decrease in serum DHT"

A 2002 Austrian study [3] did something similar:

"Patients with Gleason score 2 to 6 PCa had higher testosterone values (420 ng/dL) at baseline than did those with Gleason score 7 to 10 PCa (220 ng/dL ...)"

"Although 12 months after RP no changes in testosterone were observed in the low Gleason score group, the testosterone levels more than doubled in those with high-grade tumors."

It's clear that cancer in the prostate is able to exercise a profound effect on the hypothalamic-pituitary axis.

It suggests that the lower T often found at diagnosis may not be causal, but rather, an artifact of the disease,

Going way back to 1979 [4]:

"Regional radiation treatment of prostatic carcinoma produced significant increases in serum follicle-stimulating hormones at 3 and 12 months posttreatment from 6.5 ... to 15.9 ... mIU per ml and 19.5 ... mIU per ml ... respectively."

"Serum luteinizing hormone also increased at 3 months from 4.5 ... to 6.1 ... mIU per ml ..."

"There were no changes in sex steroid-binding globulin, testosterone, or prolactin. The data indicate damage to the testes as a result of scatter from radiation treatment to the prostate."

The new study: "measured serum levels of luteinizing hormone, follicle stimulating hormone (FSH), total testosterone (T), free testosterone, and estradiol at baseline and at 3 and 12 months after treatment completion."

("Ninety two patients underwent RP and 28 patients EBRT exclusively.")

"Luteinizing hormone and FSH levels were significantly higher in those patients treated with EBRT at three months (luteinizing hormone 8.54 vs. 4.76 U/l, FSH 22.96 vs. 8.18 U/l ...) while T and free testosterone levels were significantly lower (T 360.3 vs. 414.83ng/dl ..; free testosterone 5.94 vs. 7.5pg/ml ..)."

"At 12 months FSH levels remained significantly higher in patients treated with EBRT compared to patients treated with RP (21.01 vs. 8.51 U/l ..) while T levels remained significantly lower (339.89 vs. 402.39ng/dl ...)."

Unfortunately, there are a couple of significant differences in the populations. The RP men were younger ("64.3 vs. 71.1 years") & had higher prostate volume ("55.1 vs. 36.5 g"). I don't know if/how that might affect the findings.

-Patrick

[1] ncbi.nlm.nih.gov/pubmed/272...

[2] ncbi.nlm.nih.gov/pubmed/967...

[3] ncbi.nlm.nih.gov/pubmed/124...

[4] ncbi.nlm.nih.gov/pubmed/429120