Prostate Cancer Coverage from Every Angle

Preradiation Testosterone Levels and Aggressiveness of Prostate Cancer

By: Joseph Fanelli
Posted: Monday, September 21, 2020

For patients with prostate cancer who have been treated with radiation therapy and undergone prostatectomy or prostate radiotherapy, higher prostate-specific antigen(PSA) levels appeared to be associated with higher testosterone levels, but the connection between a patient’s Gleason score and testosterone is unclear, according to findings presented in Andrologia. Although Gleason scores of at least 8 were more frequent in patients with hypogonadal testosterone levels, that same correlation was not seen in multivariate analysis, concluded Fred Saad, MD, of the University of Montreal, and colleagues.

“The more aggressive the prostate cancer…or the higher the PSA, the more likely that testosterone levels were normal,” the authors observed. “Further studies are needed to elucidate the interaction between testosterone and Gleason score.”

The authors identified 380 patients with prostate cancer who had received primary or postoperative radiotherapy. At the time of radiotherapy, baseline testosterone levels and body mass index (BMI) measurements were available.

On multivariate analysis, the authors found that PSA levels were predictive of testosterone levels of between 10.4 nmol/L and 12.0 nmol/L. Patients with a Gleason score of at least 8 were found to be more likely to have testosterone levels less than 8 nmol/L, compared with patients with a lower Gleason score (31% vs. 20%, respectively).

After univariate analysis, a Gleason score of at least 8 was associated with a lower likelihood of having a normal testosterone level (at least 8 nmol/L). On multivariate analysis adjusted for postsurgical versus primary prostatectomy or prostate radiotherapy and BMI, the Gleason score was found to have lost its statistical significance.

Disclosure: For full disclosure of the study authors, visit

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