Podcast 36 - Does Testosterone Cause Prostate Cancer?

Transcription

Chad: This is Dr. Chad Edwards and you are listening to Podcast number 32 of Against the Grain. Are you tired and fatigued? Are you frustrated with doctors because they just don’t seem to listen? Do you want to fix your pain without surgery? If you answered yes to any of these questions, then we are the clinic for you. We offer Tulsa prolotherapy, PRP or platelet rich plasma therapy and stem cell injections, IV nutritional therapies, bioidentical hormone replacement therapy, and functional medicine to help you get back on track to optimal health. Call our clinic at 9-1-8-9-3-5-3-6-3-6 or visit our website at www.revolutionhealth.org to schedule your appointment today.

Male: Welcome to Against the Grain podcast, with Dr. Chad Edwards, where he challenges the status quo when it comes to medicine. We get into hot topics in the medical field with real stories from real patients to help you on your way to a healthy lifestyle. Get ready, because we are about to go Against the Grain.

Marshall: Hello, this is Marshall Morris and I’m today joined by one and only Dr. Chad Edwards who believes that 80% of medical recommendations are crap, technically speaking there, Dr. Edwards. He’s the author of Revolutionize Your Health with Customized Supplements, he served the US Army for 23 years, he is a board certified family physician, he is the founder of revolutionhealth.org and the Against the Grain podcast. Dr. Edwards, how you’re doing?

Chad: Man, I’m– Let me tell you, I am fired up today. It’s just been one of those days. I’m ready to rock and roll and talk about some bull crap Tulsa prolotherapy.

Marshall: Okay, so what are we getting into? What is the hot topic for today?

Chad: So our hot topic for today is going to be testosterone replacement therapy which we’ve discussed before but specifically as it relates to prostate cancer. Okay, so the women don’t have to worry about that.

Marshall: Okay, so this is immediately crushing half of our listeners today. All the women, that they’re listening. Maybe it doesn’t apply to them but they could still be interested.

Chad: Well, if you’re married, then you’re concerned about your husband developing prostate cancer. If you might be married, you might be concerned about your– you might become married if you’d ever been married or if you have a dad or a brother or a son, whether or not they’re ever going to be married Tulsa prolotherapy.

Marshall: So what you’re saying is it really does apply to every single person listening.

Chad: Yes, I think it does. And part of the issue is that– even if– there’s a couple of points that just kind of resound, if you can get through the specifics that we’re talking about prostate cancer. There’s a couple of points that resound over and over again. We talk about these all the time. We based these medical recommendations on a bunch of bull crap and then we say it applies to all these people and it’s just hog wash.

So we’re going to use that theme as we do often on Against The Grain.

Marshall: So why is this a hot topic?

Chad: Because the prevailing thought, what I was taught in medical school, residency, all those kinds of things, whether they told me specifically or I was just kind of like– the thing was that, oh you got to be really careful about that testosterone stuff because it causes prostate cancer.

Marshall: They just straight up told you that? What they were hailing as fact.

Chad: Correct. So you get these ideas and these notions and most doctors don’t have time to go dig into the research and look at it themselves and so well, I heard that it cost prostate cancer and then you might come across one source somewhere and you’re, oh well see right there, I read it on the internet that it causes prostate cancer so we can’t do that.

Marshall: Well, okay. So let’s get into it. What is this– you said testosterone replacement therapy, which we’ve covered before– give us a brief refresher.

Chad: Yes, so testosterone– low testosterone, and there’s a couple of different definitions. One of them is outside of the quote normal reference range. If you have any questions about what normal is, then reference the second podcast where we discuss how we get those normal ranges for labs. It’s important to understand that because it applies to a lot of things Tulsa prolotherapy.

So someone that has, depending on the lab, maybe a testosterone level below 300 would be defined as having low testosterone and then certainly, if we want to optimize testosterone levels and there’s a number of reasons why we want to do that, I’d reference you back to the previous testosterone replacement therapy podcast but as to why we would want to replace testosterone– so we are talking about giving exogenous, meaning outside the body, giving testosterone to men whose testosterone levels are not optimal, so that’s what we’re talking about with testosterone replacement.

Marshall: Okay, and so why do– I mean what studies have been done to show that testosterone replacement therapy does or does not cause prostate cancer or give me a little bit of the history and the evidence backing this or let’s get into some of the hard facts.

Chad: Yes, so this all started– and this is just the crap that comes up. This all started, this idea, this notion that testosterone causes prostate cancer came from a study done by Dr. Huggins. H-U-G-G-I-N-S. Huggins. His study, his paper was published in Journal of the American Mediucal Association in 1941. So we’re talking about data that’s 65 years old. Okay so this is old, old, old stuff, been around for a long time. And one of his statements in this study was all known types of adult prostatic epithelium, that’s one of the tissues in the prostate, undergo atrophy when androgenic hormones are greatly reduced in amount or inactivated. So we see prostate cancer get smaller. Atrophy means shrinking or wasting away kind of– when androgenic hormones, testosterone, are greatly reduced in amount or are inactivated. So if we make testosterone go away, we see prostate cancer shrink. That was his thought.That was a quote from his study.

So he did the study. He actually took a page, and I can’t make this crap up, this is just what happened. He castrated his patient. He cut him off. Sure did that. And he observed that prostate cancer decreased, shriveled up. So that was further validation of his theory. But he also injected two patients with testosterone replacement therapy, and he saw that their prostate cancer increased. So, when you look at this study again from 1941, one patient got his nuts cut off, the other one, the other two patients has testosterone and their prostate cancer a little bit worse. So one prostate cancer got better after getting his nuts cut off, two of them got worse with the administration of testosterone. So that’s where this notion came from Tulsa prolotherapy.

Marshall: And that was the entire study?

Chad: Essentially, yes.

Marshal: Oh, wow.

Chad: That was basically it. So we’re talking a study where we made testosterone go away because when you cut off the gonads, the testes, then you don’t make much if any testosterone. So he induced hypotestosterone, made their testosterone levels go away, and their prostate cancer decreased. So I don’t know about you but I suspect that you’re kind of attached to your gonads.

Marshal: At least, physically. [laughs]

Chad: Yes, It’s kind of a thing, so I don’t want them to go away. Nor do I want my testosterone levels to be too low. There’s lots of reasons and you can reference the other podcast in the past about testosterone replacement, why we want optimum levels. But then try to balance this with prostate cancer thing. So, the whole notion came from this study in 1941 by Dr. Huggins. And so then they say, well that’s all you need. We saw it. One time. And so don’t do that. And again, that’s crap Tulsa prolotherapy.

So there are multiple studies that have been done since then, that would– We’re going to go over those. That would say it doesn’t cause prostate cancer. It just simply doesn’t. So how do we reconcile– and we’ll save the saturation model– and how we reconcile this for after the break. So I’ll leave that for a minute. So let’s talk about a couple of studies that kind of disprove this.

So in 2008, there was a study that was published that had 3886 men with a history of prostate cancer. So all these guys had prostate cancer, and then we had 6438 men that didn’t have prostate cancer. All of these guys– so it’s roughly what? 10,000 guys, 10,200, somewhere in there. And they measured their free testosterone, their total testosterone, DHEA, and sulfate, androstenedione, androstenediol and estradiol. It’s a bunch of hormones. The estradiol obviously is an estrogen. The rest of those are androgens. They are male, predominantly male hormones.And what they saw is that there were no correlations between any of these levels and prostate cancer. Whether they had prostate cancer or did not.

Marshall: Of all these things that they tested.

Chad: Correct. So, the levels were not correlated with the frequency of cancer. It’s just an association study but there was no correlation here. Another study, this was done by Gun and Goold, and it was a review of 16 studies, and they saw no increase in prostate cancer over baseline and some of these studies went 15 years and I believe that was in men getting prostate cancer. I can’t remember if it was just looking at levels and the rest for prostate cancer and there was no association between the testosterone level and prostate cancer over base line. Another study 1365 men that were on testosterone replacement therapy and they did this for over 20 years they performed a digital rectal exam and that is what we call the one finger wave so that’s where you get accosted by your physician.
Marshal: That is a doctor slang right there.
Chad: That’s right, exactly so it’s a stick a finger up the poop shooting and check the prostrate and measuring also what’s called PSA or prostate specific antigen and we see some corelations between the level of PSA and prostate cancer. That don’t always mean that but we see some correlations there.
The rectal exam and the prostrate, the PSA was measured every six months and what they found is that there was no difference between the total PSA, the free PSA and prostate cancer compared to base line risk. When you look at men just their normal natural risk give them testosterone replacement therapy for 20 years and it didn’t change their risk of prostate cancer or their PSA free or total.
The statement in this study was kind of interesting because it says testosterone treatment is safe for the prostrate and it also improves early detection of prostate cancer, now we got to understand that they were measuring, checking this every six months. Now we’re on to say testosterone treatment with regular monitoring of the prostrate maybe safer for the individual. So we got this study from 1941 that says we increase the risk of prostate cancer and we got this one that says actually getting prostrate– I mean getting testosterone actually is safer according to this.
Another study 13 men with low testosterone and untreated prostate cancer, so they weren’t doing anything, they weren’t getting chemo, they didn’t have their prostrate cut out, they didn’t do anything like that. Only 13 men with low testosterone, untreated prostate cancer received testosterones replacement therapy for two and a half years.
Their testosterone increased, and this is important because they actually measured testosterone levels, testosterone increased from a base line of 238 that’s low on pretty much every lab I can think of and it went up to 664.
Now I would argue that is a much much better level. And they noticed there was no increase in their prostate specific antigen that PSA or in prostate volume and they actually– I don’t know if they measured that by the digital rectal exam or they actually performed ultra sound looking at the size of their prostrate, they probably looked at the ultra sound. But 54% of these patients in the follow up, in their follow up biopsies showed no prostate cancer at all in fact their prostate cancer had gone away. We’re giving them testosterone and their prostate cancer went away. Again the first study we talked about by doctor Huggins says when you get, when you make testosterone go away it causes your prostate cancer to go away, this one says when you give testosterone it makes your prostate cancer go away, kind of interesting.
We got a paradox here and we got to fix this. Another study 10 patients with organ confined prostate cancer, that means it was confined to their prostrate had not spread, underwent radical prostatectomy that means they go in and cut out, surgically remove their prostrate the entire thing. They were treated with testosterone and their PSAs were followed. 19 months later there was no increase in their PSA and there was no recurrence of their prostate cancer, pretty cool. We got several studies here that show that testosterone replacement is safe for the prostrate and we got one study that was based on cutting the dudes nads off and there was regression in his prostate cancer so we have a problem because the studies are conflicted in so far as that goes and I will tell you a study I mean you brought up a point that was the study.
A study with a very small number of patients is not regarded as a base line study. It’s not a gold standard study, you really can’t put any credence on that. In fact the scientific evidence will rate or they’ll rank level of recommendation so it will be like a level 1A recommendation, I mean that is equated right up there with crap. I mean it’s an observation, it’s not really a scientific study, there is a little bit of merit to it and after we come back from the break we will talk about what that means and how do we resolve that study with the rest of the studies.
Marshal: Okay, let’s take a quick break.
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Marshal: Okay Dr. Edwards , let’s get back into this , we’re talking about testosterone replacement therapy and the correlation to prostate cancer and you just gave us a whole list of all these studies that at no point indicate that testosterone replacement therapy actually causes prostate cancer.
Chad: That’s correct.
Marshal: Why don’t you summarize all these? What are all these pointing to?
Chad: Yes, so multiple studies show that there is actually a decrease– well, I shouldn’t say that. There is not an increased risk for prostate cancer when patients are receiving testosterone replacement therapy.
Some studies show that there is actually some regression but then you have this baseline 1941 observation by Doctor Hagen that says when they gave, when they cut your nads off that the prostate cancer got better. Again a single case where they did that, and I don’t know anyone that would volunteer to have their testicles removed in the hopes that their prostate cancer gets better. I just– that’s beyond me. I don’t know of anyone that would raise their hand under any circumstances to say, “Remove my testicles.”
Marshal: That’s a different episode.
Chad: Maybe, maybe Katelyn Jenner.
Marshal: Well that’s, yes, that’s a different episode.
Chad: Yeah that’s a different episode for sure. Although He or She?
Marshal: He or She.
Chad: She still has those parts right?
Marshal: Prostate?
Chad: No the…
Marshal: I couldn’t confirm or deny that.
Chad: Okay. I thought you had lunch with him.
Marshal: No.
Chad: No? Okay. Sorry. The way we resolve this is by what’s called the Saturation Model. We know that when testosterone levels fall below a certain level that– You know Dr. Hagen was correct in saying that these adult prostate epithelium undergo atrophy when these androgenic testosterone hormones are either greatly reduced in amount or inactivated. We know that to be true but low testosterone confers risk to a number of things, again a reference to previous podcast. So we want higher levels but how do you resolve that it doesn’t get worse with higher levels and it’s what’s called Saturation Model. Once we reach a certain level of testosterone, and it’s relatively low– different sources state different things, I’ve seen one source that said when you get above a 100 on your testosterone, I’ve seen one that is in the 200, regardless it was low. Once you get above that level on your testosterone there is no additional growth of the prostate. There is no additional risk of prostate cancer in the prostate.
Once you saturate the Prostate with testosterone, it doesn’t make any difference. You could have 250 or you can have 1259 it makes no difference. When you look at the risk to overall health for having low testosterone, I would argue that those– it is better to have optimal levels of testosterone. Most of these guys are going to have levels above that saturation level anyway. Do you want to go down to nothing to see your prostate go away? And then the number of guys that come into my clinic complaining of extreme fatigue and all kinds of problems and how bad they feel an all those– I’m talking some guys are barely able to get out of bed. It’ not like I want to jump over a tall building or, in a single bound like I can’t function. That level of stuff. There is a big contrast there. I would argue that, get your testosterone replacement therapy, the studies are done. To kind of summarize this whole thing there was Dr. Morgan Tailor he’s one of the leading expert in testosterone, he’s done a lot of studies on testosterone, a lot of the reviews and things like that. He published a study in 2006 in the Journal of European Neurology and he said– he’s a neurologist I believe. He said there, “is not now, nor has there ever been a scientific basis for the belief that testosterone causes prostate cancer to grow.”
From one of the authorities on testosterone published in peer reviewed journals, well respected in the testosterone community says, “There is not now nor has there ever been a scientific basis for this thought.” Yet another thought process in the medical community that is just pure crap.
Marshal: So, you have a lot of patients that might have some type of testosterone issue and they come to you, or they go to their doctor and they say, “Hey I really feel like this could be a solution to some of the problems,” or maybe they don’t know maybe it’s the doctor saying, “I’d love to prescribe testosterone replacement therapy as a solution but I’m scared of increasing the risk of prostate cancer”. And so, all these studies are showing that while some of them have shown to actually decrease the risk they’re at least showing there’s no increase in risk?

Chad: That’s correct.

Marshal: So, it is a viable option for those patients that are looking for that type of treatment.

Chad: Absolutely, I believe the scientific evidence is clear and consistent that there is not an increased risk of prostate cancer associated with the use of testosterone replacement.

Marshal: What would you say to any of the listeners out there that are wanting to have this type of conversation with their doctor or somebody that’s knowledgeable on this subject?

Chad: Well, I go back to the foundation of what I often talk about, make sure you have a relationship with your doctor and your doctor is willing to listen to what you have to say. You know, if you go into your doctor and say, “Well, I was listening to a podcast the other day and this doctor said blah blah blah,” he’s going to say, “Your doctor’s an idiot”. Well, I would say then at that point, I mean not that you want to get into an argument with your doctor, but what’s your basis? Because most of the time there isn’t a basis. It’s just– it’s kind of like what I call “The Baptist dilemma.” I’ve sat in the same pew every Sunday for the last 50 years so that’s what I do. There’s not a basis for that, it’s just everybody around you knows that’s your pew. So, what do you do when someone else is sitting in your seat I mean is there going be a fight? But many of these doctors don’t know where did this come from, where did that thought process come from and what are the studies that show that it’s safe. Is there any other study and if anyone is listening and you have a study that shows that testosterone increases risk of prostate cancer I will be happy to read through that study and see if there’s any validity. But, I’ve got several that show that there’s not.

Marshal: Okay, so what can listeners do if they want to read more about this or connect with the team at revolution health?

Chad: Yes, go to revolutionhealth.org if you’re in the area certainly give us a call 918 – (935) – (3636) talk to Jenn and she’ll get you scheduled. Come in and see us we’ll talk about testosterone replacement therapy, we’ll measure your levels see if you’re a good candidate and then we’ll discuss the different forms of testosterone replacement. We got one– in one of the next podcasts, in fact I think it’s the next podcast, on one of the options for testosterone replacement.

Marshal: Cool Dr. Edwards thank you so much.

Chad: Thanks Marshall.

Marshal: Thanks for listening to this week’s podcast with doctor Chad Edwards. Tune in next week when we’ll be going Against the Grain.