Is there a connection between testosterone level and severity of prostate cancer at diagnosis?

Does this answer seem correct to you. I asked my hospital a question:

Question to hospital

In prostate cancer, is there a correlation between testosterone levels at diagnosis and Gleason score. Or, to ask it another way, it is possible to prevent or delay progression of 3-3 prostate cancer by maintaining normal testosterone levels?

Answer from hospital

We contacted the Urology department, and we were advised that there is no correlation between testosterone levels and prostate cancer grade.

I figured that low testosterone is a cause of prostate cancer, and, at the least, people who have normal levels are less likely to get prostate cancer...

15 Replies

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  • I don't know whether the answer given is correct or not but it sounds appropriate since the exact cause of PCa is not yet known. Medical researchers are continuously engaged In debating out various theories for this gene malfunction ( PCa ) most of the time without reaching consensus. Under such circumstances it is very unlikely that any hospital or their urological department would commit to a definite answer based on facts not firmly established, especially when individuals ask questions.

    You may find answers to such questions as a matter of interest only when you research yourself and possibly find the answers in some research papers presented by Urologists and Oncologists from time to time. Otherwise the hospitals may think that you are trying to test the knowledge and expertise of their urological departments by asking such questions!

    Sisira

  • From what I reaseached no one will conclude there is a correlation, bit it is my opinion that yes the endocrine system is playing a huge part. it may not be the level or a number but a shift that throws things off balance. not a medical opinion just an opinion. can you subscribe to the medical journals. I think because of your love of knowledge as well that you speak to your doctor about getting access to medical journals and to ask which ones are the cream of the crop . medical research library . they are so smazing. being surrounded by so much knowledge .

  • That answer is correct by the definitions and published understanding about Prostrate Cancer. Typically, people with PCa do not have low testosterone.

    IMHO, In some cases as Prostrate Cancer grows and the Prostrate expands in size, the testicles also increase in size to accommodate the growing call for demand of testosterone by the Prostrate Cancer.

  • Martin--I thought we had this conversation? There is definitely a Correlation between Low T and Pca, and aggressive Pca. Men who have 300ng/dl of T or less past the age of 50-55, 1 in 5 have prostate cancer with PSA's below 4 and perfect Digitals. And of the ones that get it, and found later by PSA or Digital---the lower the T score, usually indicates that a higher Gleason Score will be found. It appears, as in my case--being low T and Supplementing for 20 years to keep my T at 800 ng/dl--had no effect. The Research from my Cancer Navigators , Urologist, Oncologists and my Geneticist, all tell me, my body did not recognize the Supplementation, and whatever processes, yet to be known still maintained that I was Low T, even though I had the T, by blood test,, of a 35 year old.

    Out of the 1 in 5 above, many others eventually got Pca, that could be measured/determined--later down the road. And it follows lower T means more Aggression. The wild thing here is that those 1 in 5 if they had a biopsy--even with no symptoms, very low PSA, and great Digitals--could have all been saved from Pca before being discovered by the normal medical procedures and tests.

    Nalakrats

  • I had high T double for my age of 74 and my cancer was very aggressive with Gleason score of 10

  • Thanks. Thats good (confounding) data!!

  • This does make sense--were you sure your T doubled, or was it your PSA Doubling, T normally, without outside assistance at any age--is quite remarkable. If so It might indicate a Thyroid/Pituitary anomaly.

    Nalakrats

  • My PSA was 1.2 and less for 10 yrs straight while my testosterone was double what it should have been for my age. The eleventh year my PSA went up to 4.2 and at the time of the biopsy was already up to 10.4. My Gleason scores were 10 and the cancer was found to have spread to my bones, lives and lymph nodes. My urologist said i had a very aggressive cancer that is appearing to be less rate today.

  • Does not make sense is what I meant to say--left out the word not. Something really set off your cancer on a tear--sorry to hear that. Do you know what your pathology is from your pathology report. Do you have small cell or ductal Pca? Small cell is known to move fast. ductal's also. I have a rare ductal that my normal of a PSA of 7 or 8--which was normal for me as a user of T therapy, for body building--I always got perfect digitals, with an announcement that my prostate was smooth, soft and small to medium in size. This went on for 10 years. Then in a 10 month period my 8 went to 12, I failed a digital, and in two weeks my PSA was now 20.2 at the time of the Biopsy---3 weeks later I had surgery. My Cancer was aggressive, it went from 12 to 29.2---the PSA that is, and I scored a Gleason 9 at surgery when I was a Gleason 7 at Biopsy. So my cancer was about to run over the wall.

    Now the causes--were certainly Gene related, as I got myself Gene Mapped and I had 2 Nasty Gene Mutations--BRCA-2, and PTEN. Women with BRCA-2 Breast Cancer, have one of the hardest fights. Well at least I know what I have and with the mapping, comes a list of the clinical trials working against these Gene mutations, and what experimental drugs might today have some positive affect.

    I write this so you may consider mapping, and the things that can follow the results. If interested, go to Foundation One dot com. Call and they will explain more than I can on a blog. If on Medicare the mapping is free. Gleason's and PSA's are just measuring tools. In my opinion you need to find causation.

    Certain causations though awful in the disease process can be treated. Have Faith. Prayers are with you!

    Nalakrats

  • I cant keep it all in my head. Need someplace else.

  • I had low T and was dx'd with Gleason 8, considered aggressive, at age 66. T diminishes with age. PCa risk increases with age. Is it an age thing or a low T thing? A question yet to be answered?

  • I will give you my non-professional take. It is both an Age Thing and a Low T thing.

    I believe, as we get older and T goes down, for some men it goes down to a point that they are Medically Low T when most other men their age are not. So there is the relationship between age and T. Higher age--lower T--simple. Not simple is higher age Low T, enough to be considered Medically deficient.

    What is eating up the T at greater amounts, or Metabolizing it at Greater amounts for Medically Low T men? And whatever this process is, which is set off in my opinion by a Gene Mutation--that the Metabolic pathway/natural elimination of T to be replaced by new T from the Testes and Adrenals, is altered in favor of producing high levels of Estradiol, during metabolism of the T--depositing a certain amount Day by Day into the prostate. Until such time as the Prostate erupts with unnatural cells, which we call cancer.

    So if I am somewhat right--which I may be totally wrong--the answer may be between the Gene Mutation, and the Metabolic pathway for T elimination. Discover, how to interfere with this and you have a cure, for those that are low T and not yet DX with Pca. For us that have it--we are in a process of killing Pca cells, to stay alive, or waiting for that magic Pac-Man that seeks out and eats up cancer.

    Nalakrats

  • I think you may have it a bit backwards regarding testosterone level, but I may be wrong. If testosterone feeds prostate cancer, which it most definitely does, I would think that high testosterone would be more of an indicator for future and progression of prostate cancer mets. I don't know of any studies out there on this but if someone does, please let me know. I really want to educate myself.

  • something in the testosterone story is not quite right. and its not clear how to fix it. everyone does agree that testosterone plays an important part in the prostate and in prostate cancer. T is a sex hormone in a sex organ. But the level inside the cell is most likely what is important, and the question posed is about the level in the bloodstream, not the cell.

    To make an unrelated 'feeds' analogy: even though you need energy to fight, and you need food to have energy, it is not clear that you will fight more if you have more food. You might fight over food if it gets low. this is just an example that the 'feeds' idea does not automatically mean that more T means a more agressive PC because of logic alone, even if T "feeds" the prostate in some sense. To say that T "feeds" prostate cancer is just to say, using a different word, that T aggravates prostate cancer. It does not provide the mechanism.

    And more importantly, it does not seem to explain how prostate cancer arises, even as distict from BPH.

  • I was diagnosed at age 65 with a PSA of 5,006 and lots of bone and lymph node mets, and a higher range Testosterone level of 908.

    My "gut" feeling is that the higher range T did not in itself cause the prostate cancer and the mets. Perhaps some random error or a long term inflammation process or an environmental exposure might have started the orginal tumor? I have no way to prove that, whatsoever. However, the prostate cancer cells that I did have when my PSA was 5,006 were well established to an environment that did have a high baseline T value of 908. When I went on ADT with Lupron, my PSA of 5,006 dropped rapidly and reached a nadir of 1.0. Very responsive to hormone therapy.

    Conversely, my "gut" feeling is that if I had had a very low T baseline, my prostate cancer cells might already have been somewhat adapted to living in a lower T environment, and might have been less responsive to hormone therapy, and might have been considered more aggressive in nature when they were less responsive to hormone therapy? Again, this is only a speculation.

    (By the way, I was also screened for 50-ish familial genes such as BRCA-2, etc., but, did not test positive for any of those, which might have otherwise complicated the picture.)

    Charles

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