Low testosterone levels may indicate worsening of disease for men with low-risk prostate cancer

For men with low-risk prostate cancer, low levels of testosterone may indicate a worsening of their disease. That’s the conclusion of a new study published in BJU International. The findings may help physicians identify patients with low-risk prostate cancer who should receive aggressive anticancer treatment.

Men with prostate cancer that is not life-threatening and is only slowly progressing can often forego treatment and instead undergo active surveillance. Unfortunately, doctors currently have no reliable way of predicting which men will develop evidence of worsening or more aggressive disease during active surveillance.

Ignacio San Francisco, MD, of the Pontificia Universidad Católica de Chile, and his colleagues studied whether testosterone levels might provide any indication. The researchers found that low levels of free testosterone were significantly linked with an increased risk of developing more aggressive disease. They found no significant association with total testosterone concentrations, although there was a general trend towards increased risk with lower levels.

“These results suggest low levels of testosterone are associated with more aggressive prostate cancer. This contradicts long-held beliefs that high testosterone is risky for prostate cancer, and low testosterone is protective,” says Dr. San Francisco.

The study results provide valuable information to clinicians and their patients concerning risk factors for prostate cancer progression in men undergoing active surveillance. “In borderline cases, the presence of low values of free testosterone may help determine whether it is more prudent to initiate treatment rather than continue observation,” says Dr. San Francisco. Read more the study abstract.