%0 Journal Article
%T Serum Testosterone Level, Testosterone Replacement Treatment, and Prostate Cancer
%A Ali Atan
%A Altug Tuncel
%A Suleyman Yesil
%A Derya Balbay
%J Advances in Urology
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/275945
%X There has been an increase in the number of individuals seeking testosterone (T) replacement treatment (TRT) due to a decrease in their blood T levels. Prostate cancer (PCa) is also an important issue in the same age group. However, we, urologists, are anxious about PCa development after T treatment. This is because it has been assumed that T may cause PCa or exacerbate insidious PCa which is already present. In this paper, recent developments regarding the relationship between serum levels of sex hormone and prostate tissue, the causal relationship between T and development of PCa, the effect of TRT on the group of patients who are at high risk of developing PCa, the suitability of TRT for patients who have already been diagnosed with PCa, and the effect of TRT on serum prostate-specific antigen level are analyzed. 1. Introduction According to the Bureau of Census of the United States, the population of men over the age of 65 that is 35 millions in year 2000 will reach 40, 54.6, and 70 millions by years 2010, 2020, and 2030, respectively [1, 2]. According to another study conducted in Germany, it is estimated that 1/3 of the population will be over 60 years and that 11% will be over 80 years of age by year 2050 [3]. Serum testosterone (T) level in men has been shown to be decreased significantly with aging in both cross-sectional and longitudinal studies [4¨C7]. Therefore, the number of patients needing T replacement treatment (TRT) due to a decrease in their T levels secondary to aging is increasing. Despite the accumulating knowledge on the effects of T, many still continue to carry a suspicion on the use of T. Until recently, regarding prostate cancer (PCa), TRT has been indisputably considered as adding fuel to the flames or feeding a hungry tumor [8]. It was scared that TRT will cause PCa or flare up occult PCa which stemmed from the studies of Huggins and Hodges in 1941 [9]. According to their work, PCa regressed when serum T levels had been reduced and progressed when exogenous T had been given. However, there has been no clear evidence reported since then that men receiving or with high T levels have had an increased risk of developing PCa [8, 10]. On the contrary, in a large prospective study investigating the correlation between high levels of circulating T and risk of PCa, higher levels were found to be related to reduced risk of PCa [11]. Additionally, there have been several contemporary reports stating that decreased serum T levels can be a marker for occult PCa [12]. PCa has a much more aggressive course regardless of disease stage in
%U http://www.hindawi.com/journals/au/2013/275945/