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Testosterone Levels and Their Impact on Prostate Cancer
Testosterone, the primary male sex hormone, plays a complex role in the development and progression of prostate cancer. Research indicates that testosterone levels at diagnosis can significantly influence survival outcomes. Jussila et al. (2025) found that patients with low testosterone levels (< 8.0 nmol/L) at the time of diagnosis exhibited a 67% increased risk of mortality compared to those with normal levels (> 10.4 nmol/L) (Jussila et al., 2025). This association underscores the potential of testosterone as a prognostic biomarker in prostate cancer.
Table 1: Testosterone Levels and Mortality Risk
| Testosterone Level (nmol/L) | Risk of Mortality (HR)* |
|---|---|
| >10.4 | 1.00 |
| 8.0–10.4 | 1.03 |
| 2.0–8.0 | 1.67 |
*Hazard Ratio (HR) values from univariable Cox regression analysis.
Association Between Testosterone and Overall Survival in PCa
The relationship between testosterone levels and overall survival in prostate cancer patients is not merely observational; it reflects a biological interplay between testosterone and cancer progression. Low testosterone levels may indicate a more aggressive form of prostate cancer, correlating with higher grades on the International Society of Urological Pathology (ISUP) scoring system. Patients with low testosterone levels frequently present with more advanced disease, which exacerbates the risk of mortality (Jussila et al., 2025).
Table 2: ISUP Score Distribution by Testosterone Levels
| Testosterone Level (nmol/L) | ISUP Score 1 (%) | ISUP Score 2 (%) | ISUP Score 3 (%) | ISUP Score 4 (%) | ISUP Score 5 (%) |
|---|---|---|---|---|---|
| >10.4 | 35.1 | 17.8 | 18.4 | 14.2 | 3.9 |
| 8.0–10.4 | 34.4 | 16.3 | 16.3 | 21.8 | 2.7 |
| 2.0–8.0 | 29.3 | 15.4 | 17.3 | 17.8 | 9.6 |
Implications of Testosterone Measurement in Prostate Cancer
The measurement of testosterone levels at diagnosis offers valuable insights for tailoring treatment strategies. Clinicians can utilize testosterone measurements to stratify patients based on risk, facilitating personalized treatment plans. For instance, patients with low testosterone may benefit from closer monitoring and more aggressive interventions to mitigate the risk of mortality associated with their condition (Jussila et al., 2025).
Table 3: Recommendations for Testosterone Measurement
| Testosterone Level (nmol/L) | Clinical Recommendation |
|---|---|
| >10.4 | Routine monitoring and follow-up |
| 8.0–10.4 | Increased surveillance and assessment |
| 2.0–8.0 | Consider aggressive treatment options |
The Role of Comorbidities in Prostate Cancer Prognosis
Comorbidities, such as diabetes and metabolic syndrome, are prevalent among prostate cancer patients and can significantly impact survival outcomes. Jussila et al. (2025) highlighted that patients with low testosterone levels often have a higher prevalence of comorbid conditions, reflecting a poorer overall state of health. The interplay between testosterone levels and comorbidities complicates the clinical management of prostate cancer, necessitating a holistic approach to patient care.
Table 4: Comorbidities Associated with Low Testosterone
| Comorbidity | Prevalence (%) in Low Testosterone Group |
|---|---|
| Diabetes mellitus | 34.5 |
| Metabolic syndrome | 25.3 |
| Essential primary hypertension | 49.4 |
FAQ
What is the significance of testosterone levels in prostate cancer survival?
Low testosterone levels at diagnosis are associated with a higher risk of mortality in prostate cancer patients, indicating its potential role as a prognostic marker.
How do comorbidities affect prostate cancer prognosis?
Comorbidities can complicate the clinical management of prostate cancer and are often linked to poorer survival outcomes, particularly in patients with low testosterone levels.
Should testosterone levels be routinely measured in prostate cancer patients?
Yes, measuring testosterone levels can help stratify patients based on risk and inform treatment strategies for improved outcomes.
References
- Jussila, I., Ahtiainen, J. P., Laakkonen, E. K., Käkelä, P., Parviainen, M., Pohjolainen, H., et al. (2025). Testosterone levels at diagnosis: A key predictor of overall survival among patients with prostate cancer. BJUI Compass. https://pubmed.ncbi.nlm.nih.gov/11832296/
- (Additional references would go here following the same format, if applicable.)
