The Role of Low Testosterone in Prostate Cancer Progression
NEW YORK, NY--(Marketwired - May 22, 2014) - Researchers have identified low testosterone, or Low T, as a potential biomarker of prostate cancer acceleration. In a review of men diagnosed with low-risk prostate cancer, those with low testosterone were at increased risk of developing a more aggressive form of the disease. The findings counter current beliefs that Low T acts as protection against prostate cancer.
The study also sheds light on the tentative nature of a low-risk prostate cancer diagnosis and the risks associated with active surveillance. Robotic prostate surgeon, David Samadi, MD, Chairman of Urology and Chief of Robotic Surgery at Lenox Hill Hospital, is optimistic that studies like this will help men make more informed, targeted prostate cancer treatment decisions.
"The discovery of new biomarkers for aggressive prostate cancer highlights the disease's unpredictability," said Dr. Samadi. "A low risk diagnosis can change with little or no warning, and it's important for men to understand that before postponing treatment."
Active surveillance involves the decision to not treat prostate cancer or to postpone treatment. It usually requires frequent screening to monitor the disease's status and watch for signs of aggression. If the disease is believed to have the potential to progress or increase in severity, some men then opt for treatment. As prostate cancer experts like Dr. Samadi caution, determining that point can be very difficult and may jeopardize the chance to eradicate what was once an isolated tumor.
Chilean researchers followed low-risk men for a period of three years. During that time, more than a third opted to treat their prostate cancer based on disease reclassification, while the remainder continued with active surveillance. Men with free testosterone levels below 0.45 ng/dL were more likely to be reclassified to have aggressive prostate cancer than those with normal or high levels. The increased risk was independent of prostate-specific antigen (PSA) level, prostate volume, average age, and family history of prostate cancer.
"Early-stage prostate cancer diagnosis, whether low-risk or high-risk, is a valuable opportunity," stressed Dr. Samadi. "Very effective treatment options like robotic surgery, allow us to address the disease while it is contained in the prostate. Until we can predict a man's disease timeline with more certainty, definitive treatment offers the best assurance for the future."
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