Prospective Study of Sex Hormone Levels Among Prostate Cancer Patients Attending University of Port Harcourt Teaching Hospital Clinic

Abstract

Background: Longstanding and diverse body of evidence supports the view that sex steroids play a role in the development of prostate cancer. Epidemiological and demographic studies in humans as well as animal
experiments have sought to determine the independent effect on risk as well as the interrelationship between these hormones. In this study, we investigated the variations in testosterone and oestradiol levels among prostate cancer patients attending UPTH clinics with the objective of determining the role played by sex hormone variations in the development of cancer of prostate in patients attending the University of Port Harcourt Teaching, Port Harcourt.
Methods: Newly diagnosed patients with cancer of the prostate attending the Urology clinic of University of Port Harcourt Teaching, Port Harcourt from December 2011 to April 2012 were recruited for the study. Their Prostate Specific Antigen (PSA) testosterone and oestrogens levels were measured using Elisa Kits. Correlation between individual hormone levels in control subjects were assessed by Spearman correlation coefficients (R). Student t-test was used to assess if there was any significant difference between the patients and controls in the level of these hormones. We computed the ratio of oestradiol to testosterone and compared case patients with control subjects by use of t-test at 95% confidence interval. Test cases were also divided into two groups by age to study variations across subgroups.
Results: 105 patients recently diagnosed with prostate cancer and 40 normal subjects were analyzed. We observed a negative correlation between testosterone and oestradiol (r = -0.66). Testosterone and oestradiol levels in prostate cancer patients were also significantly different from that of controls. Mean testosterone level in control was 3.2 ng/ml while that of the patients was 4.0 ng /ml. Mean oestradiol level in controls was 32.8 pg/ml while that of the patients was 21.2pg/ml (p < 0.05 in both cases). The ratio of oestradiol to testosterone was also significantly altered
in prostate cancer patients (p < 0.05). The mean levels of hormones and hormone ratios across the two sub-age groups were not substantially different in patients with prostate cancer (p > 0.05).
Conclusion: This study indicates that increased levels of testosterone in circulation are associated with risk of prostate cancer. This risk is further associated with low levels of circulating oestradiol. The relative levels or ratio of these hormones are very important in the development of prostate cancer. Age of the patient appear not to be strongly related with these changes after the cancerous state has set in.

Key Words: Prostate cancer, oestrogens, testosterone, Prostate Specific Antigen (PSA).