Relationship between endogenous testosterone and prostate carcinoma

Prostate cancer incidence is rising rapidly worldwide, which includes Asian countries too. There are a lot of controversies regarding the link between endogenous testosterone levels and prostate disorders. This study was conducted to understand the value of serum testosterone in predicting the risk and occurrence of prostate carcinoma.

Eighty males in the age group of 50-80 years, out of which forty were diagnosed as Prostate cancer patients and forty were healthy controls matched with respect to age and sex, were recruited in the study. Serum testosterone and serum prostate-specific antigen levels were estimated in both groups.

Serum testosterone levels were low in 67.5% and normal in 32.5% of the patients of prostate cancer. In comparison with the controls, serum PSA levels were observed to be higher in prostate cancer patients (P < 0.001). Analysis of the data was done with the help of an unpaired t-test, and P < 0.05 was considered to be statistically significant.

Androgens promote cellular differentiation and proliferation of prostate epithelial cells via the genetic alterations in the TMPRSS2 gene and ETS (E26 transforming sequences) transcription factor genes involved in cell proliferation and tumor cell invasion. These genes are found to be over-expressed in prostate carcinomas. Suppression of testosterone by prostate cancer-induced production of inhibin that initiates the hypothalamic-pituitary axis negative feedback mechanism might be the reason for lower levels of serum testosterone in prostate carcinoma patients. Hence, screening of elderly men above 60 years of age for serum testosterone levels should be done for early identification of prostate carcinoma as well as a better prognosis in the management of the disease.