Eur Urol. 2006 Nov;50(5):935-9. Epub 2006 Jul 27.
Eur Urol. 2006 Nov;50(5):895-7.
Testosterone and prostate cancer: an historical perspective on a modern myth.
Morgentaler A.
Beth Israel Deaconess Medical Center, Harvard Medical School,
Boston, Massachusetts, USA. amorgent@bidmc.harvard.edu
OBJECTIVES: To review the historical origins and current evidence for the belief that testosterone (T)
causes prostate cancer (pCA) growth.
METHODS: Review of the historical literature regarding T administration
and pCA, as well as more recent studies investigating the relationship of T and pCA.
RESULTS: In 1941
Huggins and Hodges reported that marked reductions in T by castration or estrogen treatment caused metastatic
pCA to regress, and administration of exogenous T caused pCA to grow. Remarkably, this latter conclusion was
based on results from only one patient. Multiple subsequent reports revealed no pCA progression with T
administration, and some men even experienced subjective improvement, such as resolution of bone pain. More
recent data have shown no apparent increase in pCA rates in clinical trials of T supplementation in normal
men or men at increased risk for pCA, no relationship of pCA risk with serum T levels in multiple
longitudinal studies, and no reduced risk of pCA in men with low T. The apparent paradox in which castration
causes pCA to regress yet higher T fails to cause pCA to grow is resolved by a saturation model, in which
maximal stimulation of pCA is reached at relatively low levels of T.
CONCLUSIONS: This historical perspective
reveals that there is not now-nor has there ever been-a scientific basis for the belief that T causes pCA to
grow. Discarding this modern myth will allow exploration of alternative hypotheses regarding the
relationship of T and pCA that may be clinically and scientifically rewarding.
PMID: 16875775 [PubMed - indexed for MEDLINE]
