Testosterone and Prostate Cancer: What’s the Connection?

Doctors are always very eager to offer all kinds of advice as to how you can go about treating it. But when it comes to defining what actually causes prostate cancer in men, the experts often draw a blank. They just don’t know, which isn’t all that reassuring when they’re the same folks recommending that a guy go under the knife or subject his reproductive area to radiation for treatment.

How can conventional medicine claim to know how best to treat prostate cancer using these types of invasive procedures if they don’t even know why it develops in the first place? It’s a nagging question that I’ve found myself asking over the years as I continue my quest for answers to the growing problem of cancer across our country and around the world.

According to the American Cancer Society, roughly one out of every seven men will develop prostate cancer at some point throughout his life. One in 39 men will end up dying from it. Prostate cancer is the third leading cause of cancer death among men overall, right behind lung cancer and colorectal cancer.¹

These are sobering statistics, and perhaps even more so the fact that things weren’t always like this. Prostate cancer was virtually unheard of prior to 1853 when its first known incidence was described in The Lancet as “a very rare disease.” A surgeon named J. Adams from The London Hospital inadvertently discovered it during a histological examination of one of his patients. It was something that he and his colleagues had never before seen, and likely never could have imagined would become such a widespread problem.²

Fast-forward more than a century-and-a-half and we’re now at a place where more than 161,000 men will develop prostate cancer and more than 26,000 will die from it this year – just in the USA alone.³ To say that this doesn’t sit well with me would be an understatement – and I’m guessing you probably feel the same. But I’m determined to get to the bottom of this issue because the trends suggest that things are only going to get worse, not better. I don’t want myself or the men in my life – or the men in yours – to suffer this dismal fate.

The Problem With PSA Screening

Like with most other forms of the disease, the standard medical approach to dealing with prostate cancer isn’t necessarily prevention, but rather to screen for it on a routine basis. Doctors will do this for prostate cancer using a PSA test, which measures the level of prostate-specific antigen in a man’s blood as an indicator of potential prostate issues.

The idea is that the higher the level of PSA, the greater the chance that a man has a prostate condition like benign prostatic hyperplasia (BPH) or prostatitis. Or, in a worst-case scenario, full-blown prostate cancer.

Since it was first introduced back in the 1980s, the PSA test has been praised as one of the most useful tools for identifying prostate cancer in its earliest stages, which is when it’s easiest to treat. But there are problems with PSA testing that suggest it isn’t always beneficial for men’s health.

One of these is over-detection, as not all cancers that show up during PSA screening will ever become detrimental during a man’s lifetime (some are benign, in other words). This results in men being unnecessarily treated for a non-disease using aggressive approaches that can actually cause significant harm in the long-term.⁴

Another problem is that PSA screenings may not even be accurate in the first place. At least not in the way they’re used as proof to suggest that high PSA levels directly contribute to prostate cancer, as is widely believed. Just as a high PSA level doesn’t necessarily indicate the presence of prostate cancer, a low PSA level doesn’t necessarily mean that a man is in the clear. It simply means that there could be a problem that requires further investigation.

What about men over the age of 65, which represent the group most likely to develop prostate cancer (and to experience elevated PSA levels)? These men often suffer from declining testosterone levels that require major dietary and lifestyle changes, and possible treatment with testosterone replacement therapy (TRT).

Men who undergo TRT often experience a rise in their PSA levels, a correlation that some experts believe points directly to testosterone as a contributing factor to prostate cancer. But is there actually proof to back this?

Are Androgens Such as Testosterone Really a Cause of Prostate Cancer?

It depends, especially when you consider the fact that the least likely group to develop prostate cancer – younger men – have naturally high levels of testosterone. If testosterone really did contribute to prostate cancer, then every young man in his prime would have it, which simply isn’t the case. (It is important to note that an increasing number of testosterone-deficient men, both young and old, are now developing prostate cancer. This actually suggests the opposite about the nature of testosterone and prostate cancer.)

It could be that exogenous testosterone (meaning from an external source outside the body)  in the form of TRT is to blame, and that endogenous, or natural testosterone, acts differently on the prostate. But even this hypothesis has its drawbacks. Consider that an extensive meta-analysis – the widest of its kind ever conducted – that was published in the journal BJU International back in 2016 found that neither endogenous nor exogenous testosterone has any real impact on a man’s PSA levels, or on his risk of developing prostate cancer.⁵ In fact, testosterone and other related androgen hormones in men seem to have a beneficial effect, as they’re absolutely vital for male health and development.

An evidence-based review published one year prior in the journal Therapeutic Advances in Urology came to similar conclusions about the role of androgens (male sex hormones) – mainly that they help offset prostate problems rather than contribute to them.⁶ Having low testosterone is actually much more problematic for men’s health in general, it turns out⁷ – a fact that completely turns the “androgen hypothesis” of prostate cancer onto its head. What this all suggests is that mainline thinking on the subject is severely flawed, if not completely misguided and false.

Too Much Estrogen Is Another Major Risk for Prostate Cancer

So if testosterone really isn’t the culprit in prostate cancer formation, what is? The latest evidence suggests that estrogen – and way too much of it – is a major contributing factor to prostate issues, including prostate cancer. While men and women require both testosterone and estrogen to stay healthy, there must be a proper balance of the two respective to individual sex. Women generally need more estrogen than testosterone, in other words, and men generally need more testosterone than estrogen. This is a rather simplistic way of putting it, but I believe it gets to the heart of the issue, and it seems to highlight the biggest area of men’s health where conventional medicine just can’t seem to get it right.

It seems like men everywhere these days are suffering from various symptoms of estrogen dominance. Yet their doctors aren’t properly identifying this abnormality in order to help men come up with a workable solution. These same doctors are also failing to pinpoint the many factors that contribute to estrogen dominance in the first place – things like poor diet, lack of exercise, and too much stress.

Men who consume too much sugar and too many simple carbohydrates, for instance, are doing prolific damage to their bodies. Excess sugar consumption promotes insulin resistance, which drives down testosterone levels and generates a buildup of body fat – particularly around a man’s midsection and even in his chest. If you’ve ever heard the term “man boobs,” this is exactly the type of thing I’m talking about here. Excess abdominal fat is one very clear sign that a man has too much estrogen and not enough testosterone inside his body.

Alcohol is another substance that many men don’t realize contributes to estrogen dominance. The craft beer craze has driven perhaps more men than ever before to take up a drinking hobby, but it most certainly isn’t doing their hormones any favors. Men who consume excess amounts of alcohol tend to develop “beer bellies” that indicate decreased levels of testosterone and elevated levels of estrogen. By cutting alcohol from one’s leisurely routine, a man can help jumpstart the journey towards improving his blood sugar profile, and thus help to optimize his testosterone levels while keeping estrogen in check.

From the perspective of eating, sticking to a “Paleolithic” or ketogenic diet can have a tremendous impact on helping a man to achieve optimal hormone balance. Exercising regularly, getting an adequate amount of rest every night, staying hydrated, and avoiding stress (as stress elevates cortisol levels, which lead to further declines in testosterone) are further beneficial in helping to minimize a man’s risk of developing prostate abnormalities.

With all that said, it’s clear that hormones inside the body are, indeed, a primary – if not the primary – factor in whether or not a man develops issues with his prostate. But it’s not testosterone that’s the problem: it’s too much estrogen. In many cases this can be effectively addressed by making simple dietary and lifestyle changes (that obviously require discipline, which is probably the hardest part). But as I always say: prevention is the best medicine.

My advice for men is this: don’t wait until a problem develops before you make a change; do what you can today to avoid the problem entirely so you can live a healthy, lively, and energetic life.