Paradigm Shift in the Concept of Hormonal Milieu of Prostate Cancer

A study involving 3,886 prostate cancer cases and 6,438 matched controls found no association between circulating androgens and the risk of prostate cancer, regardless of tumor stage or grade. This indicated that prostate cancer risk and tumor aggressiveness were not related to serum levels of total and free testosterone. However, the findings did not negate the role of androgens in prostate cancer but highlighted the importance of androgen metabolism within the prostate. The exact contribution of testosterone and dihydrotestosterone (DHT) from adrenal androgens or other steroid precursors to the prostate remained unclear.