Information about Prostate Cancer

Autopsy studies have shown microscopic evidence of prostate cancer in 15 to 30 percent of men over the age of 50 and in 60 to 70 percent of men who reach age 80. These numbers have led some experts to theorize that every man will develop some degree of prostate cancer if he lives long enough.

Although the number of men diagnosed with prostate cancer has increased with the widespread use of the prostate-specific antigen (PSA) blood test for screening, prostate cancer death rates began to decline and level off after 1993. Many experts believe that earlier detection of prostate cancer through routine use of the PSA test was responsible for the declining death rates. This has been a matter of great debate, but recent evidence supports this contention.

A boy born today has a 16 percent chance of being diagnosed with prostate cancer at some time in his life and a 3 percent chance of dying of the disease. The good news is that statistics from a large national health database indicate that the vast majority of men diagnosed with prostate cancer will live as long as men in the same age group who never develop the disease.

Ask the Doctor about Prostate Cancer

Q: Is it true that testosterone replacement therapy can increase the risk of prostate cancer?

A: A study from Johns Hopkins, published in BJU International, found that older men with the highest levels of free testosterone in their bloodstream were more likely to develop aggressive prostate cancer. This supports the idea that supplemental testosterone might be harmful.

But other studies have linked low testosterone levels to an increased risk of prostate cancer, worse five-year survival, higher Gleason scores and more cancerous samples on biopsy, and worse pathological stage. How can this be?

It's well known that men with higher testosterone levels are more likely to develop prostate cancer. The question is whether this truly implicates testosterone. For example, it's possible that prostate cancer cells secrete an androgen inhibitor that lowers levels of testosterone in the bloodstream. Or testosterone therapy might influence the body differently over time. For instance, it might offer some protection against prostate cancer in younger men without cancer cells, and promote its progression in older men who already have cancerous cells.

Until more is known, we recommend avoiding testosterone therapy unless it's essential to your well-being. A recent study in the Journal of the American Medical Association found that testosterone therapy failed to improve quality of life, so there seems to be no reason for most men to use it.

Publication Review By: H. Ballentine Carter, M.D.

Published: 12 Apr 2011

Last Modified: 30 Jun 2011