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Prostate cancer: the role of estrogen

Introduction.

Despite the general belief that higher serum testosterone increases the risk of developing new and rapid growth of latent prostate cancer (PC), recently, some scientists attribute testosterone only a secondary role. And the emphasis is being shifted onto its direct derivative-estradiol.

In a man’s body, the enzyme aromatase converts about 0.3-0.4 % of testosterone (T) into estradiol (E2). Probably, the labeling of these compounds as the male’s and the female’s hormones allowed E2 to stay in the shade, while the high T content and its well-known anabolic properties attracted much more attention regarding malignant cell growth. Moreover, for the last eight decades, evidence has been directly pointing to T in fuelling prostate cancer.

This belief has resulted in a fear of T therapy for cancer patients, and all kinds of men suffering from low T. Evidence-based education of the general public about the true relationship between T, E2, and PC may help change public consciousness and facilitate future progress in this demanding area. Let’s try to analyze the available data and understand how these two hormones affect the development of prostate cancer.

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Testosterone and prostate health

Introduction

For over 75 years, it has been accepted that higher serum testosterone increases the risk of developing both new and rapid growth of latent prostate cancer. How did it happen that testosterone, being a hormone controlling the development of the prostate early in life, becomes a destruction and degeneration factor of the prostate in old age? What is the price of risk of testosterone therapy, and does it prove the expected benefits? There is considerable evidence that androgen deprivation therapy noticeably depresses the development of prostate cancer in humans and prostate cell line experimental systems. However, there is no clear evidence that an increase in endogenous testosterone levels contributes to the development of prostate cancer in men.
Let’s study the issue carefully, analyzing the pros and cons of available evidence-based data.

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