Both High and Low T Are Risk Factors

[gusgold]

urotoday.com/recent-abstrac...

[pjoshea13]

Gus,

Too bad the abstract gives no details of the 5 groups.

I doubt that they were quintiles, since the highest T was 800 ng/dL & higher. How many men in our group had T=>800 ng/dL at diagnosis?

More likely, with andropause reduction, T would be closer to 400 ng/dL than 800.

Note the first sentence:

"Androgen-androgen receptor (AR) signal is known as a powerful driver of prostate cancer progression."

"Driver" is bad enough, but "powerful"? Shows a bias against androgen. Amazing that PCa in the first fifty years of life is so rare with such a powerful driver on the loose.

I would certainly be interested in that 800 & up group. How much excess risk was there, compared to 400 ng/dL, say? Did the authors have a hypothesis?

Morgentaler's saturation model says that AR has all the T it needs at ~250 ng/dL. Above 799 ng/dL, how does excess T affect already saturated AR?

-Patrick

ncbi.nlm.nih.gov/pubmed/289...

Anticancer Res. 2017 Oct;37(10):5559-5564.

Both High and Low Serum Total Testosterone Levels Indicate Poor Prognosis in Patients with Prostate Cancer.

Izumi K1, Shigehara K2, Nohara T2, Narimoto K2, Kadono Y2, Mizokami A2.

Author information

Abstract

BACKGROUND/AIM:

Androgen-androgen receptor (AR) signal is known as a powerful driver of prostate cancer progression. We previously reported the limitation of prostate-specific antigen (PSA) at diagnosis as a prognostic biomarker of prostate cancer. Although serum total testosterone (TT) level has been reported as a prognostic biomarker for prostate cancer, its usability is still controversial. We examined the potential and characteristics of TT as a biomarker.

PATIENTS AND METHODS:

Serum TT levels of patients who underwent prostate biopsy were measured, and prostate cancer-specific survival (PCaSS), overall survival (OS), and the correlation between staging and serum TT level were analyzed.

RESULTS:

Of 379 biopsied patients, 255 were diagnosed with prostate cancer. The patients were divided into five groups according to their serum TT levels; patients with serum TT levels of <2 or ≥8 ng/ml (ENDs) had worse PCaSS and OS compared with those with middle serum TT levels between 2 and 8 ng/ml (MIDs). Moreover, ENDs showed a tendency of having castration-resistant cancer with advanced stage (T4 or N1 or M1). The TNM stage in ENDs was significantly higher than in MIDs.

CONCLUSION:

Although low serum TT level has been reported to indicate worse outcome in patients with prostate cancer, this study showed that both low as well as high serum TT levels indicate poor prognosis.

Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

KEYWORDS:

Biomarker; overall survival; prognosis; prostate cancer; total testosterone

PMID: 28982870 DOI: 10.21873/anticanres.11988

[Hidden in reply to pjoshea13]

Were the higher T men receiving supplementation? Is that why their T levels were higher than would be expected based on their age? Remember a few years ago when ads for T supplementation products saturated the TV air waves? Don't see those ads much any more. Did the lawyers put an end to this marketing, with their own ads trolling for men who had used this supplementation and maybe got PC, which they would have gotten anyway?

[pjoshea13 in reply to Hidden]

Good point. How do men get into the PCa age range with T above 800 ng/dL?

It's a Japanese study.

If supplementation explains it, these men might have spent significant time with very low T levels before getting treatment. Thereby increasing PCa risk.

-Patrick

[Hidden]

That's just great. My T has been zip for a few years now, and I'm reaching eight years with St.4 PCa. I was given 10-15 years, but I feel way better than that.

Joe