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testosterone and prostate cancer

YTW's picture
YTW
Posts: 63
Joined: Apr 2010

I posted the following on another and recieved one reply of which I am confused.
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Jimmy Posted: Thursday, February 24, 2011 8:30 AM

I have read that taking saw palmetto supplements is both good and bad for PCa. It is suppossed to reduce the production of testosterone (good) and at the same time artifically reduce the results of PSA blood tests, (bad). Any suggestions? Thanks.................................................. Jimmy/Cleveland

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Posted: Thursday, February 24, 2011 11:30 AM

What you read was wrong on many counts:

(1) There is no evidence that reducing the natural production of testosterone is a "good" thing for reducing risk of early or intermediate stage cancer.

Data from all published prospective studies on circulating level of total and free testosterone do not support the hypothesis that high levels of circulating androgens are associated with an increased risk of prostate cancer. Instead they indicate that high levels within the reference range of androgens, estrogens and adrenal androgens decreases aggressive prostate cancer risk. Indeed, high-grade prostate cancer has been associated with low plasma level of testosterone. Furthermore, pre-treatment LOW total testosterone was an independent predictor of extraprostatic disease in patients with localized prostate cancer; as testosterone decreases, patients have an increased likelihood of non-organ confined disease and low serum testosterone levels are associated with positive surgical margins in radical retropubic prostatectomy.

(2) For those who suffer from advanced androgen-dependent PC, there are much more effective androgen blockers than saw palmetto.

(3) Saw palmetto blocks DHT, not testosterone.

(4) And, according to the following study, it does not interfere with PSA:
Serenoa repens (Permixon) inhibits the 5alpha-reductase activity of human prostate cancer cell lines without interfering with PSA expression.

VascodaGama's picture
VascodaGama
Posts: 1533
Joined: Nov 2010

Jimmy

The answer you received is confusing. I think that whoever sent you that explanation implied the meaning to advanced cases such as patients who have been on HT as their prime treatment or survivors who have failed radical treatments, but whose cancer cells are not androgen independent.

Saw Palmetto (Serenoa Repens) is a natural 5-ARI "drug" which does not alter the PSA levels. Synthetic 5-ARI (Finasteride or Avodart) are known to alter the PSA levels lowering it in about 50%.
The fact can be taken as “good” because SP will permit to use an unmasked PSA measurements as a useful biomarker, but it can be “Bad”, as you said, because SP does nothing on the cancer itself. Finasteride is known to prevent prostate cancer acting not just on the prevention of the “production” of DHT (as do SP) but as well on the “destruction” of the cancer.

DHT is produced from testosterone, and the 5-ARI prevents testosterone from being converted into the more potent form Dihydrotestosterone. Inhibition of 5-alpha reductase results in decreased production of DHT, increased levels of testosterone, and, perhaps, increased levels of estradiol, which in turn could cause Gynecomastia as a side-effect.

I hope my insight helps.
VGama

YTW's picture
YTW
Posts: 63
Joined: Apr 2010

Now I think that I'm beginning to understans.

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