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Testosterone Levels in Benign Prostatic Hypertrophy and Prostate Cancer

Circulating testosterone, are known to play key roles in prostate growth. The underlying mechanism of action remains unknown because androgen mediates complex interactions among many prostate growth factors, hormones and cell lines. Prostate cancer has often been linked with low testosterone levels. The incidence of prostate cancer is greatest in elderly patients because testosterone concentrations drop with age.The introduction of PSA for the diagnosis of prostate carcinoma has undoubtedly increased the detection rate of localized tumours. As PSA has low specificity, particularly in screening programmes, surrogates are being sought e.g. PSA density, velocity or free/total ratio. Despite this, a reliable, easy to use, marker of prostate cancer still remains to be found.

The present evidence shows that prostate cancer is associated with lower testosterone levels than Benign Prostatic Hypertrophy (BPH). As patients with prostate cancer have lower testosterone levels than patients with BPH, could testosterone levels have a potential diagnostic value? Multiple logistic regression models suggests that testosterone reached statistical significance and became an independent predictor of disease status, and provides that the higher the testosterone levels the lower the risk of prostate cancer.

However, studies have some limitations. Since patients with symptomatic BPH were included, the results may not necessarily apply to a screened population. Furthermore, follow up may be too short to assessing prostate cancer occurrence in so-called “BPH group”. Most important, the limited number of recruited patients adds a limitation to study conclusion, especially in designing a specific nomogram. However, these interesting preliminary results suggest a Testosterone test should be included in baseline evaluation of every patient with prostate disease.

Tags: benigh prostatic hypertrophy, prostate cancer, testosterone levels