Testosterone Deficiency Is Not Protective Against the Development of Adenocarcinoma of the Prostate in a Type 1 Diabetic Patient

April 2022 in “ Diabetes Therapy ”

David S. H. Bell, Terri Jerkins

testosterone hypogonadism prostate cancer prostate-specific antigen dihydrotestosterone adrenal androgens androstenedione 5α-reductase 2 low testosterone PC PSA DHT

Studysummary In this case report, the researchers emphasize the importance of regular prostate exams and PSA tests for diabetic men, including those who are hypogonadal, because prostate cancer development is linked to intraprostatic dihydrotestosterone levels, not serum testosterone levels. Our plain-language summary of this paper — not a Tressless recommendation.

This document reports a case where a patient with well-controlled type 1 diabetes and hypogonadism (low testosterone levels) developed prostate cancer (PC). The case highlights that despite a lower incidence of PC in diabetic males, and the common belief that low serum testosterone might be protective against PC, regular prostate exams and prostate-specific antigen (PSA) measurements are still crucial. The development of PC is linked to dihydrotestosterone (DHT) levels within the prostate rather than serum testosterone levels. In hypogonadal males, intraprostatic DHT may remain high due to the conversion of adrenal androgens like androstenedione by the enzyme 5α-reductase 2, which is typically not dominant in a normal prostate but becomes significant in the development and growth of PC.

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research Development of Prostate Cancer in a Patient with Primary Hypogonadism: Intratumoral Steroidogenesis in Prostate Cancer Tissues

10 citations , October 2012 in “Andrology”

In this case study, researchers observed that steroidogenesis from adrenal androgens in prostate cancer tissues may explain progression in a 74-year-old man with low circulating testosterone.

research The Dihydrotestosterone Hypothesis of Prostate Cancer and Its Therapeutic Implications

57 citations , January 1986 in “The Prostate”

This article discusses the role of dihydrotestosterone in human prostatic adenocarcinoma growth and suggests that 6-methyleneprogesterone could be used to inhibit DHT for treating hormone-responsive prostate cancer, without new clinical findings.