Scientists from the MD Anderson Cancer Center at the University of Texas have found that prostate cancer patients with low testosterone levels face a higher risk of the disease progressing to a more aggressive form. The study was published in the Journal of Urology.
Today, men with early-stage prostate cancer are often managed with a strategy known as active surveillance. Doctors regularly monitor the patient’s condition and begin treatment only if there are signs that the disease is progressing. This approach helps avoid or delay surgery and other therapies. However, one of the key challenges is identifying patients whose cancer may progress more rapidly.
“Active surveillance is a safe and effective option for many men with early prostate cancer. But it is important to understand which patients are at higher risk of disease progression,” said the study’s lead author, Justin Gregg, an associate professor of urology and specialist in medical disparities.
In the study, researchers analyzed clinical and pathological data from more than 900 men undergoing active surveillance. They assessed baseline testosterone levels and tracked how the disease developed over time.
The results showed that patients with low testosterone levels — 300 nanograms per deciliter or lower — were significantly more likely to experience progression of the disease to grade group 3 or higher, which is considered a sign of a more aggressive form of prostate cancer.
The association remained even after accounting for other risk factors, including patients’ age, prostate-specific antigen (PSA) levels, body mass index, as well as tumor density and size.
The authors emphasize that the findings do not mean that low testosterone directly causes aggressive cancer. Rather, it may serve as an additional biomarker that helps more accurately assess the risk of disease progression.
According to the researchers, considering testosterone levels at the time of diagnosis could help doctors better determine monitoring strategies and the frequency of examinations for patients.
At the same time, the scientists note that further studies are needed to confirm the results and determine how reliably testosterone levels can be used to predict the course of the disease in individual patients.
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