A whole new way for testosterone to reach the prostate?

It has long been clear that testosterone has an essential function in regulating the behavior of prostate tissues and has significant impact on the development and progression of prostate cancer. However, the way in which testosterone exerts these effects (the pathophysiological mechanism of prostate cancer) is still not well established or well understood.

In an article published today in Andrologia, Gat et al. have described “a previously unrecognized route of flow of free testosterone,” at a concentration 130 times the normal physiological levels, and which reaches the prostate through the venous drainage systems of the testes and prostate, completely bypassing the normal systemic circulation.

According to the authors, there is an age-associated effect which causes deviation of the testicular venous flow from its normal route: “This condition results from the malfunction of the vertically oriented testicular venous drainage system in humans.”

The authors also provide early results of a procedure they describe as “super-selective intraprostatic androgen deprivation therapy.” They claim that this treatment has resulted in a decrease in prostate volume, a decrease in serum PSA levels, and disappearance of cancerous cells on repeat biopsies in 5/6 patients (83 percent) in a small clinical trial. The procedure is an interventional radiologic procedure.

Gat and colleagues conclude that pathological flow of free testosterone from the testes directly to the prostate via the testicular-prostate venous drainage systems may explain the development of prostate cancer (at least in some patients). They suggest that it may be possible to eradicate localized, androgen-sensitive prostate cancer cells within a specific window of time, and that this treatment may retard, stop, or even reverse the development of the disease.

This is clearly a radical new finding that needs to be confirmed by other research groups. Should it prove to be accurate, we may have a whole new mechanism available to treat early stage disease without having to expose patients to systemic forms of hormone therapy. The “New” Prostate Cancer InfoLink emphasizes, however, that we have seen only an abstract of this report, and we need greater detail to understand what is actually being suggested by Gat and colleagues.

2 Responses

  1. Have the findings of Gat et al. been confirmed by other research groups?

  2. Unfortunately, no, not that I am aware of. On the other hand, no one has disproved them either.

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