We know that low Testosterone (but not down at hormone therapy levels) is correlated with higher Gleason score at diagnosis. This and a number of other things have debunked the original consensus since Huggins and Hodges 1940's work on Testosterone and Prostate Cancer that increasing Testosterone was related to increased risk of prostate cancer. There is a relationship, but it's certainly not linear.
It's therefore perhaps not surprising if failure of Testosterone to return to normal levels might not be great for avoiding recurrence.
One of the current theories (of which Abraham Morgentaler is a significant proponent) is the saturation theory. This is that the prostate is saturated with Testosterone at the lower limit of the normal range. It can't make use of higher levels and they don't do it any harm. However, being below the lower normal limit (but not as low as castrate level) might be the most harmful level in terms of prostate cancer risk, and it is these low levels which most correlate with high Gleason scores.
This may also be why being overweight, although not increasing your chance of getting prostate cancer, certainly does increase the probable Gleason score, the chance of being diagnosed later, and the chance of dying from prostate cancer. Being overweight reduces Testosterone levels because body fat contains Aromatase, an enzyme which converts Testosterone into Estrogens, so your Testosterone level drops as more of your Testosterone is converted into Estrogens.
Edited by member 03 Mar 2025 at 13:45
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