Risk of Prostate Cancer? Check Your Hairline

Prostate cancer is the leading cancer among American men, but little is actually known about its causes or risk factors. Androgens — male sex hormones — are necessary for the growth and functioning of the prostate gland and contribute to the growth of tumors of the prostate. Androgens are also necessary for the growth and development of hair. A new study expands on this association and reports that men with prostate cancer are more than twice as likely to have had male pattern baldness beginning at age 20 than men without prostate cancer.

The recent study, published in Annals of Oncology, evaluated 388 men who had been diagnosed with prostate cancer and 281 controls without prostate cancer. The average age of the group with cancer was 67.2 years, and the control group, 66.4 years. Other than prostate cancer diagnosis, the groups had similar family and medical histories. The men in both groups were asked to report their own, as well as their father’s, history of prostate cancer. They also described their pattern of balding at ages 20, 30, and 40.

The researchers concluded that any balding at age 20 was associated with a two-fold increased risk of prostate cancer later in life. Early balding was not associated with an earlier cancer diagnosis, nor with being diagnosed with aggressive types of tumors. No association was found between balding at ages 30 or 40 and increased prostate cancer risk.

Increased androgen levels have long been associated with both prostate cancer and baldness, and androgen-based treatments have been used for the treatment of both conditions. For example, finasteride (marketed by Merck under the brand names Proscar and Propecia) is an anti-androgen that inhibits the conversion of testosterone to dihydrotestosterone, the active metabolite of testosterone in the body. It is used to treat benign prostatic hypertrophy, prevent the occurrence of certain types of prostate cancer, and treat male pattern baldness.

Prostate cancer is the most common cause of death from cancer in men over age 75. It rarely occurs in men younger than 40. While age over 60 years and African-American race are the most well-known risk factors, in addition to a positive family history of prostate cancer, certain behaviors can reduce the risk of developing prostate cancer: limit alcohol consumption, reduce the amount of fat in the diet, and avoid exposure to certain hazardous chemicals. However, there is truly no way to prevent prostate cancer. Luckily, in the United States, treatment options for prostate cancer are highly effective and response rates are generally high. Many prostate cancers may be cured completely. And, even in patients whose cancer cannot be cured entirely, many treatments are available that can extend the duration and quality of life. Anecdotally, it is said that many men die with prostate cancer, not from prostate cancer.

Though the sample size of the current study was small, and self-reporting contains inherent bias, the study confirms earlier reports that prostate cancer and baldness might be linked. The production of androgens in the development of prostate cancers needs further investigation, but early balding appears to be a simple marker for prostate cancer. Whether men with early-onset balding would benefit from routine prostate cancer screenings early in life, or these men should be systematically treated with agents like finasteride remains to be seen.

References

Demark-Wahnefried W, Conaway MR, Robertson CN, Mathias BJ, Anderson EE, & Paulson DF (1997). Anthropometric risk factors for prostate cancer. Nutrition and cancer, 28 (3), 302-7 PMID: 9343840

Demark-Wahnefried W, Lesko SM, Conaway MR, Robertson CN, Clark RV, Lobaugh B, Mathias BJ, Strigo TS, & Paulson DF (1997). Serum androgens: associations with prostate cancer risk and hair patterning. Journal of andrology, 18 (5), 495-500 PMID: 9349747

Denmark-Wahnefried W, Schildkraut JM, Thompson D, Lesko SM, McIntyre L, Schwingl P, Paulson DF, Robertson CN, Anderson EE, & Walther PJ (2000). Early onset baldness and prostate cancer risk. Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology, 9 (3), 325-8 PMID: 10750672

Sofikerim M, Eskicorapci S, Oruç O, & Ozen H (2007). Hormonal predictors of prostate cancer. Urologia internationalis, 79 (1), 13-8 PMID: 17627161

Yassa M, Saliou M, De Rycke Y, Hemery C, Henni M, Bachaud JM, Thiounn N, Cosset JM, & Giraud P (2011). Male pattern baldness and the risk of prostate cancer. Annals of oncology : official journal of the European Society for Medical Oncology / ESMO PMID: 21324955