For the last 50 plus years we have been told that testosterone causes prostate cancer, ever since Huggins et al demonstrated that suppression of testosterone caused prostate cancer regression. Over the last 70 years this fact has grown and morphed into testosterone being the cause of prostate cancer, with statements made by physicians such as “testosterone in the face of prostate cancer is like throwing gas on a fire”. We will look at the newest studies available and soon, you too, will think that is as silly as the earth being flat.
Prostate Cancer and Testosterone
1941 Huggins and Hodges reported that with castration and subsequent near zero testosterone levels (castrate levels of testosterone) metastatic prostate cancer regressed and with testosterone supplementation the prostate cancer grew. The latter observation was based on one patient. Multiple studies since that time have demonstrated no association with testosterone supplementation and prostate cancer. In more recent studies there has been no increase in prostate cancer incidence in patients receiving testosterone supplementation and no decrease incidence of prostate cancer in men with low testosterone levels. How to explain this observation by Huggins and Hodge, that won them a Nobel Prize in Medicine? Current studies would suggest that there is a saturation point for the prostate at which all receptors for testosterone (DHT) are filled . This level is extremely low-level and that after you exceed this no further prostate stimulation is obtained. In laymen terms: It isn’t anything like gas on a fire, but more like pouring water on a plant that is in a saturated pot with the exceeds running off.
Myths and Assumptions
Down through history we have fallen victim to myths, embellishments and assumptions. Testosterone is extremely important to men especially as they age, decreasing the incidence of many of the diseases that we all associate with the aging process. Because of this false assumption many physicians have refused older men the benefits of testosterone, leading to an unnecessary decrease in quality and possible quantity of life. I know there is more work to do but this is the first step in getting physicians to be open to new studies and face the facts. Doctors the world isn’t flat!
Many of us remember the story of Christopher Columbus who intended to set sail to discover the new world. Many thought he was crazy but not because he would fall off the edge of the world. That is a myth, the truth was by that period they knew the earth was a sphere but they didn’t know how big. If by chance the earth was much larger than projected there would be no way to have a succesful journey and he and his men would all perish. Lucky for him they were close in their calculations and you know the rest of the story.
This all boils down to the same thing each physician learned while residents, but selectively apply. When you assume you make a……….
ASS of U and ME
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