Changes in the levels of testosterone profile over time in relation to clinical parameters in a cohort of patients with prostate cancer managed by active surveillance

Testosterone therapy may reduce prostate cancer risk due to testosterone deficiency at a young age via stabilizing serum testosterone levels

Objectives: To investigate whether testosterone replacement therapy (TRT) reduces prostate cancer (PCa) risk via stabilizing serum testosterone (T) levels beyond simply elevating serum T levels and whether TRT reduces PCa risk due to low serum T levels at a young age.Methods: We analyzed data of 776 hypogonadal men from a urology center in Bremerhaven, Germany through 2004-2016 to investigate whether the TRT group has more stable T levels and whether TRT can reduce the risk of PCa due to low serum T levels at an early age. We derived an index, Maximum Decline of T Relative to Baseline (MDRB), to describe the magnitude of T declines and variations over time.Results: We found the TRT group has more stable serum T levels (e.g. smaller drop-offs) during the follow-up period as compared to the non-TRT group, and the mean of MDRB is significantly higher in the untreated group (1.553 nmol/L VS 0.013 nmol/L; p-value < .001). TRT significantly reduces the risk of PCa associated with T deficiency at a young age (p-value = .00087).Conclusions: TRT may reduce PCa risk via maintaining serum T levels within individual's normal range; T surveillance may be needed for males who have low serum T levels at a young age to monitor abnormal variations of T levels and ensure timely treatment when necessary to reduce PCa risk.

Family history of prostate cancer and age-related trend of testosterone levels among US males: NHANES 2003-2004

BACKGROUND

Studies have suggested that rapid age-related declines of testosterone (T) level may play a critical role in the development of prostate cancer (PCa), and family history of PCa is another well-established risk factor of PCa, which have been reported to be associated with androgen metabolism-related genes. However, few studies have ever investigated whether a family history of PCa influences the risk of PCa via regulating the age-related trend of T level among males over the life course.

OBJECTIVES

To examine the association between family history of PCa and age-related trend of T levels.

MATERIALS AND METHODS

We used National Health and Nutrition Examination Survey (NHANES) data from 2003 to 2004 (n = 322) to compare the age-specific T levels in males with a family history of PCa and those without.

RESULTS

We found that between two younger age groups (ages 20-39 and 40-59), there was a more pronounced drop-off in T levels among men with a family history of PCa compared to men without a family history.

DISCUSSION AND CONCLUSION

This preliminary analysis suggested that men with a family history of PCa may experience a sharper decline in T level over the life course as compared to males without a family history. However, no conclusions can be made due to small sample sizes. Further longitudinal studies with large sample sizes are needed.