Increasingly research shows that prostate cancer is more likely linked to low levels of testosterone but has far more to do with levels of estrogen in men; but this runs counter to the history and current treatment of prostate cancer; could this be a reason for the poor statistics on the disease?
The alarming growth of prostate cancer
The numbers of men dying from prostate cancer in the UK has hit an all time record at over 12,000 in 2017. According to Prostate cancer UK one of the three main reasons for this, is the increased incidence of the cancer returning unexpectedly. Why, you might ask, would this be happening? (Writes Chris Woollams, former Oxford University Biochemist.)
Actually, the question of whether orthodox medicine might not be wonderfully effective for prostate cancer was put into sharp focus by an Oxford University study in 2016. Professor Freddy Hamdy and his team concluded that there is 'Absolutely no survival advantage in having orthodox medical treatment for a newly diagnosed prostate cancer patient after 50 years of age (4)". You might think that he might have done something wrong in research, but actually this was the fifth and by far the largest study of its kind!
Back in 2006, I turned down an article for icon magazine. It was an interview with the head of prostate cancer at a leading cancer hospital in London. In the interview he said that prostate cancer was "all about high testosterone levels and how they found that giving people high doses of oestrogen, the female sex hormone, would cut testosterone and increase survival times". Remember back then, castration was an option. I used to joke in speeches around the world, that if prostate cancer was really all about high testosterone levels, then every 18 year old boy would have the disease!
Fortunately in 2020, we don't throw high doses of oestrogen at men to suppress their testosterone levels any more. But men with prostate cancer will know of drugs such as Zoladex that aim to reduce their testosterone. And there's a new breed of testosterone-lowering drugs that really do cut almost all of it (and depression is a major side-effect). In fact, and I quote from the American Cancer Society, the aim of Hormone Therapy - also called Androgen Deprivation Therapy, or Androgen Suppression Therapy - is "to reduce levels of male hormones called androgens and to stop them fueling prostate cancer cells". Apart from Zoladex, there are 13 other drugs to cut your testosterone in various ways, including Lupron, Trelstar, Vantus, Abiraterone, Degaralix, Ketoconozole, Flutamide, Bicalutamide, Nilutamide. A side-effect of commonly-used Zoladex is that it increases blood fat levels. We will return to this later.
No link between prostate cancer and testosterone
In 2015, we covered this: Dr. Peter Boyle of The International Prevention Research institute reviewed two 'Meta-studies' and, presenting his findings at the American Urological Association's Annual Symposium, he stated that serum testosterone levels had absolutely no links to PSA levels nor to risk of Prostate Cancer. He went on to say that the use of testosterone supplementation - in cases of hypogonadism - also showed no links to increased risk of prostate cancer. He was very clear about this - no link between testosterone and prostate cancer.
Go to: No link between testosterone and prostate cancer
A 2016 study(5) followed men who had prostate cancer and were on Active Surveillance (’Watch and Wait’) and showed that those given more testosterone across a three year period resulted in no increase in prostate cancer growth or aggression.
Also in 2016, a team from Baylor College, Harvard Medical School and others went further. In their own meta-analysis, they showed that high testosterone was neither a risk factor for prostate cancer, nor did it increase progression. Moreover they talked about how LOW testosterone was linked in some studies to risk and progression and even advocated looking into Testosterone Therapy for prevention and treatment of prostate cancer!! When I interviewed Professor Robert Thomas on my Sunday Show in 2021 (The video is in the CANCERactive Community), he confirmed the same. It looks like prostate cancer occurs more in men with lowered testosterone.
But this was all known as long ago as 1994 when a study of 180 male blood donors at Oslo University Hospital, reviewed those who subsequently developed prostate cancer and found no link to their previous testosterone levels (9). Two years later the Japan-Hawaii Study on 141 male samples reviewed their total testosterone, and 4 other androgens. 20 years later the study concluded that "none of these levels of androgens is strongly associated with prostate cancer risk" (10).
Prostate cancer risk and oestrogen
Put simply, testosterone in men makes us lean and mean. Around the age of 50 our testosterone levels start to decline and we increase our fat stores. At the same time levels of oestrogen (estrogen) start to rise. We know from research that higher body fat levels in men are linked with higher levels of oestrogen, and that overweight men develop more prostate cancer.
In women, for example, oestradiol is known to be made by aromatase enzymes in their fat stores and is strongly linked to breast cancer. It is termed aromatisation. Oestrogen-positive breast cancer patients are given aromatase inhibitor drugs to stop this and cut their estrogen levels. Not so men.
Back in 2005/6, we presented research in articles in icon and still on this Website that showed men had a higher risk of an enlarged prostate if their oestrogen (estrogen) levels increased. Other factors - like obesity, saturated fat and dairy consumption have a straight line direct link to prostate cancer, according to research from the Kaolinska Institute in Sweden. All are factors associated with higher levels of oestrogen and IGF.
And men who are night-shift workers and thus have disturbed melatonin production get more prostate cancer; as do women get more breast cancer. And Melatonin is a known regulator of human oestrogen and IGF. Disturbed sleep causes less melatonin production, and higher oestrogen.
And we also know that environmental chemical pollution can increase men's oestrogen levels. Common chemicals (called xenoestrogens) that once in the body can mimic the action of oestrogen reduce testosterone levels and sperm count -
* for example phthalates (2)
* for example, lead (3) ;
* for example, BPA There's a study of Chinese factory workers led by Dr. De-Kun Li, at Kaiser Permanente, California on BPA and lowered sperm counts plus a review by Dr. Ana Soto that BPA is linked to prostate cancer risk.
And we covered research in Cancer Watch that prostate cancer has also been linked to 13 such xenoestrogens.
Go to: Prostate cancer - What's the cause?
We have also looked at studies from Australia, Singapore, Japan and MD Anderson in Texas, which all pointed in the same direction: Namely that as a man ages, his oestrogen levels increase, while his testosterone levels decline. And this leads to an era of higher prostate cancer risk. Despite all this, current orthodox medical treatment for prostate cancer still aims to cut nasty old testosterone.
Yes, that's right! Prostate cancer may link to lowered testosterone, so we'll treat you by - lowering testosterone further.
Why?
Prostate cancer and aromatisation
Testosterone can itself be metabolised into oestradiol by P450 aromatase in the cytoplasm of prostate cells, increasing oestrogen at the expense of testosterone. Fact. But this is the final step of the androgen 'cascade', and the amount of testosterne turning into oestradiol produced in that way has never really been quantified and could well be small. However, based on this single 'fact'', a whole industry of drugs has been created to reduce nasty old testosterone.
This is a massive Achilles heel for the theory, because it also follows that any compound that up-regulates P450 or any molecule that mimics oestradiol could do the same job. And there are lots of those in modern man!
In a 2012 paper (11), there was a review of how stress, xenoestrogens, poor dietary choices and reactive toxins could also up-regulate the P450 aromatase pathway. Then, in combination with leptin and insulin, the oestradiol could increase metabolic syndrome (cardiovascular issues, stroke risk, type-2 diabetes) and increase fat stores. Oh, and increase prostate disease.
The real fact is that a whole drug industry is using a small piece of science and ignoring a huge piece of science. Search Google for 'aromatisation and prostate cancer' and see how little you find. Why? Who would fund it? It is embarrassing!
Go to: Natural aromatase inhibitors for prostate cancer
Again, on my Sunday Show, this time in 2022, I interviewed Judy Evans, a naturopath and expert in Natural Progesterone. And she said that Natural Progesterone - a balancer against high oestrogen in women with breast cancer, endometriosis and menopause problems, is extremely helpful for men with prostate problems. It balances (reduces) their human oestrogen levels.
But then so would weight lifting and gym work, and we see that a lot of older men derive real benefit from this,
And Black Cumin Seed - it's an adaptogen. What does that mean? Well if you are male with low sperm counts and low testosterone, it helps you raise them; but if you have high oestrogen, it helps you reduce them. Like Natural Progesterone, black cumin seed normalises you!!!
But, we can't use either of these if you are taking ADT drugs as they work in the opposite direction!
Testosterone levels falling anyway due to environmental toxins, low vitamin D levels
It gets worse. There is clear research that lowered testosterone is occurring anyway in the Western world. Why? Because of the issues mentioned above. For example:
* Thanks to environmental factors such as xenoestrogens in the water supply, herbicides, pesticides and personal care products, testosterone levels are declining in men in the Western world by approximately 1% per year - a 35 year old male in the Western world has lower levels of testosterone that his father did at the same age. Dr. Thomas Travison from the New England Research Institutes in Watertown. Massachusetts used the long-term Massachusetts' Male Aging Survey to show this. The research was confirmed by Antti Perheentupa from the University of Turku in Finland who said that when he saw another research group producing the same findings he was 'convinced we were seeing a genuine biological change'.
Apparently, these falls are most prevalent in men over 50 years of age, while levels of oestrogen are increasing. And this is the highest risk group for prostate cancer.
Another reason for declining testosterone is low vitamin D levels. Cancer charities, which do deals with sunsblock providers and warn people to stay out of the sun maybe trying to save the lives of 1600 people who die from skin cancer in the UK, but they are putting 30 million men at a greater risk of all illnesses and a shorter life! In fact, a group of health and vitamin D experts in America recently slammed charities like Cancer Research UK for causing 300,000 premature deaths a year in the USA. There is even research that shows that vitamin D levels can predict the outcome of biopsies! Low vitamin D, low testosterone and more prostate cancer
Low Testosterone is bad news for men's health in general
But the issue is not just that low testosterone is bad news for prostate cancer. It's terrible for our health in general. For example:
* We also know that the higher your testosterone levels, the lower your risk of death from any health cause. In a study of 3,942 men, the risk of death was decreased in men with higher testosterone and higher growth hormone (IGF-1) levels. High testosterone promotes health, survival and longevity(1).
* Testosterone also has an effect on brain function - and there is a 2015 meta-analysis showing that low testosterone significantly increases your risk of Alzheimer's disease(8).
* A recent review shows that low testosterone is linked to Alzheimer's, cancer and increased morbidity in men. Full stop.
There's a booming industry in the USA - testosterone supplementation!
How cutting blood fats helps in prostate cancer
We said that when males are young, their testosterone keeps them fit and lean. As their testosterone declines they become fatter. Obesity and high blood fats are linked to prostate risk. Dietary saturated fat consumption is linked to higher prostate cancer risk. And a high fat diet has been linked to more metastases and lowered prostate cancer survival.
Go to: Higher saturated fat consumption and blood fats linked to more matastases and lowered survival
And, it is not just about your fat stores around your tummy and hips, it is about the levels of cholesterol and triglycerides in your blood.
Now, remember what we said above about Zolodex putting up your blood fats?
Go to: Zolodax increases blood cholesterol and triglyceride levels
There is even research on atorvastatin - a blood-fat lowering statin - increasing prostate cancer survival times, and other studies showing that the tomato-extract Lycopene reduces prostate cancer risk, and aggressive prostate cancer and fatal prostate cancer. Why? Lycopene cuts blood fats.
(And it is an anti-oxidant, attacks cancer stem cells and stops prostate cancer using glutamate.)
What's glutamate got to do with prostate cancer?
Glutamine is a non-essential amino acid. It is largely found in animal protein and so, theoretically, consuming large quantities og glutamine might put up your blood levels. If cancer cells cannot obtain glucose, they can turn to glutamine which is converted into glutamate - a fuel for cancer. Prostate cancer seems more likely to thrive on glutamate than other cancers.
In prostate cancer, researchers found that there is a direct link between blood glutamate levels, the Gleason Score, and the aggression of the prostate cancer. I quote - "Glutamate deprivation or blockade with pharmacological inhibitors of glutamate release or metabotropic glutamate receptor 1 (GRM1) decreased growth, migration and invasion and induced apoptosis".
Alternatively we have research that Ursolic Acid (Holy basil, pistachio nuts), lycopene, turmeric, resveratrol and pomegranate also stop prostate cells feeding on glutamate.
Could the answer lie in giving testosterone to men with prostate cancer
Goodness me - it would render 14 drugs redundant! We can't have that, can we?
It’s time to talk about the work of Professor Samuel R. Denmeade, an expert in oncology and urology at Johns Hopkins Sidney Kimmel Comprehensive Cancer Center.
His team is actually studying whether giving men testosterone will improve progression-free survival times over the drug enzalutamide (Xtandi) in men with advance prostate cancer, who have already had abiraterone.
What makes this interesting is that the trial will give testosterone to prostate cancer patients whose cancer has progressed as castration-resistant. And Xtandi was developed for men whose prostate cancer progressed and spread DESPITE them having surgery or drugs to cut their testosterone!
In other words, this research is going to do the opposite of conventional theory.
The theory is called ’Bipolar Cycling’ or ’Bipolar Androgen Treatment’ (BAT) where patients experience alternate low and high levels of testosterone.
This is a part of an ongoing phase II trial, the RESTORE Trial(6) - RE-sensitising with Supraphysiologic Testosterone to Overcome Resistance. The men in the RESTORE trial are all on Zoladex or similar.
At the November 2016 Symposium on Molecular Targets and Cancer Therapeutics in Munich, results of 47 men who had BAT, alternating high testosterone with low testosterone treatment, showed that there were no side-effects and the majority of men had no cancer progression across 22 cycles, with one man apparently 'cured'. Early days yet but definitely positive signs - generally PSA fell in 40% of men; and by 50% in 30% of the trial group.
Could the answer lie with anti-oestrogen drugs?
So let's revisit the drug Dutasteride, also called Avodart, which in Australian research reduced the size of swollen benign prostates (BHP). One randomised, double blind, placebo-controlled study published in the New England Journal of Medicine, involved 6729 men, each with a PSA of 2.5 to 10.0 and one negative prostate biopsy and followed them for 4 years. Those in the Dutasteride group had a 22.8% lowered risk of developing prostate cancer. In a meta-analysis involving men with BHP, the level of prostate cancer was reduced by almost 50% in the Dutasteride group over the placebo group.
Then we come to Charles E. Myers (Snuffy), one of America's top scientists. He developed 6 top drugs and then developed prostate cancer. This he beat using old 'off-label' drugs. He treated two of my PP patients (both with bone metastases) and one of the drugs he used was Avodart. He believes the involvement of this drug contributes significantly to long-term survival in men with prostate cancer. See here - Path to durable remission in prostate cancer. (He also believe prostate cancer is largely to do with fat levels).
BUT. There is a warning from the FDA on both Dutasteride (Avodart) and Finasteride, (Proscar or Propecia), that they can increase the risk of prostate cancer and erectile dysfunction, which is bizaare when every man knows what will happen to him the moment he takes an androgen blocker.
Interestingly, the UK's Professor Robert Thomas (who created PSA-reducing POMI-T) showed that giving men newly-diagnosed with prostate cancer, lots of broccoli (in juices and soups), plus tomatoes and exercise, put their need for surgery back 4 years. Broccoli's main bioactive compound is indole3carbinol. What does it do? It denatures oestradiol and blocks its action.
The bottom line
Chris Woollams, a founder of CANCERactive and a former Oxford University Biochemist said, "It all really seems a bit of a mess. Low Testosterone makes matters worse and standard treatment is to cut testosterone! Blood fat levels make matters worse, and standard treatment raises them! Anti-oestrogens seem to do a good job and no oncologist thinks to explore an anti-oestrogen, or indole 3 carbinol, or melatonin?. Meanwhile the number of prostate deaths climb, and recurrence is a major factor. As a friend of mine with a prostate cancer a decade ago said 'there doesn't seem to be best practice in prostate cancer'. He could well be right."
Go to: Overview of Prostate cancer: symptoms, causes and treatment alternatives
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References
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4. /cancer-active-page-link.aspx?n=3392&title=Orthodox-treatment-a-waste-of-time-in-men-over-55-diagnosed-with-prostate-cancer
5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4736350/
7. https://www.globalresearch.ca/health-and-the-environment-testosterone-levels-fall-worldwide/30129
8. https://www.ncbi.nlm.nih.gov/pubmed/26154489
9. Vatten et al. Cancer Epidemiology Biomarkers Prev. 1997 Nov; 6(11): 967-9 (212). Study conducted at Department of Community Medicine and General Practice, University Medical Center, Trondheim, Norway [[email protected]]).
10. Nomura et al. Cancer Epidemiol. Biomarkers Prev. 1996 Aug; 5(8): 621-5. Study conducted at Japan-Hawaii Cancer Study, Kuakini Medical Center, Honolulu, HI 96817
11. Aromatase up-regulation, insulin and raised intracellular oestrogens in men, induce adiposity, metabolic syndrome and prostate disease, via aberrant ER-α and GPER signalling: https://www.sciencedirect.com/science/article/abs/pii/S0303720711007441