Baldness link to prostate cancer Aggressiveness in Men: In Young Men, it is a risk factor of prostate cancer.

By Dr. Raphael NyarkoteyObu

Wow! I know this is an interesting research and sets to be the talk of the month. Others may feel the heat because they are in this group; but the reality is that, Men who are losing their hair due to male pattern baldness may be at increased risk of dying from prostate cancer, a new study suggests.

Though it appears funny, we can thank the Greeks for the name doctors apply to male hormones. Androgen comes from the words meaning “man-maker,” and it’s a well-chosen term. Androgenic alopecia, commonly known as male pattern baldness, is a common disorder affecting almost 50% of men throughout their lifetime. It is usually seen in older men, but it may arise precociously. A link between male pattern baldness and androgens has previously been documented. Up to 20% of men in their twenties will have male pattern baldness, with the rate increasing among men with each decade of life and that is my concerns; those in their twenties!

Whether a man tries to fight his baldness in every way he can or embraces it with pride, what is known is the possibility of a potential connection between male pattern baldness and prostate cancer. The cause of baldness in men usually is a family history of baldness or the male sex hormones call androgens. The most potent androgen is testosterone, which is responsible for deepening a man’s voice, increasing his muscle mass, and strengthening his bones.

Testosterone can also be converted into another type of androgen called dihydrotestosterone (DHT). DHT can cause acne in addition to putting hair on a man’s chest but with a tendency to take hair from a man’s scalp.

Even though male pattern baldness and prostate cancer are two separate conditions, DHT stimulates the growth of prostate cells that contributes to benign prostatic hyperplasia (BPH) in older men.The relationship between prostate cancer and male pattern baldness is the fact that prostate cancer is a hormone-dependent disease and most hair loss in men is caused by androgenic alopecia due to the hormones of androgens.What are known risk factors for prostate cancer and male pattern baldness is the aging of men and androgens, with androgens implicated in the development of both conditions.

So at this juncture, are you at higher risk of getting aggressive prostate cancer? Results of some reviewstudies say the answer may be staring you right in the face. Actually, a little higher: in the hairline.

The studies:

One study, published in the Journal of Clinical Oncology, shows that men who have a certain pattern of early male pattern balding – specifically, loss of hair at both the forehead and at the crown – have a 40-percent higher risk of developing aggressive cancer. In this study, investigators at the National Cancer Institute, George Washington University, and the Cancer Prevention Institute of California looked at 39,070 men who had taken part in the Prostate, Lung, Colorectal and Ovarian (PLCO) Screening Trial, and asked the question, what did their hair look like at age 45?

The investigators were looking for an association between hair loss and prostate cancer. They didn’t find a link between every balding guy and prostate cancer. They also didn’t find a link between this particular pattern of hair loss, called “frontal plus moderate vertex baldness,” and overall prostate cancer risk, or the risk of developing the slow-growing kind of cancer that may not need to be treated.

Instead what they found was more troublesome, and important, and something that should make a lot of people – family doctors, internists, urologists, and men with this pattern of hair loss – take notice: frontal plus moderate vertex baldness was “significantly associated with an increased risk of aggressive prostate cancer.” This is the kind of cancer that needs to be treated, and the kind of cancer that can be deadly. In male pattern baldness, men don’t actually stop making hair. But the hair they do make morphs from hair that can grow long and abundantly into hard-to-see, tiny, baby-fine hair. From adult hair, in effect, into the kind of hair we all have as infants.

Scientists are not optimistic which genes are involved, but they do have evidence. If this were a crime scene, we might say police have no suspects, but they are interviewing a person of interest. In this case, the faulty Gene of interest is one called Maspin. It is a Tumor suppressor gene, designed to keep cell growth and division orderly, and to discourage the rampant, out-of-control growth that happens in cancer.

Mice, when the Maspin gene is disabled, develop a bald spot; they also get early prostate cancer. Another key thing happens: “When the Maspin gene is knocked out,” says medical Oncologist Jonathan Simons, M.D., CEO of the Prostate Cancer Foundation, “it allows cancer cells to move around – to migrate – and also to become more vicious, just like metastatic, high Gleason-Grade cancer in men. If we can figure out the basic biology here, we might be able not only to prevent prostate cancer in these men, but to reverse male pattern baldness.” Clearly, there is a pathway that scientists have yet to discover. “The hunt is on. Whether the Maspin gene ultimately turns out to be the cause, this research is going to give us an idea what’s going on with these men, and it involves genes shared by hair follicles that have growth cycles, and prostate cancer cells that cycle. ”

There is precedent for such a physical characteristic to be linked to a health problem. People who have freckles on their lips also are more likely to get colon cancer; this is called Putz-Jaeger Syndrome. In dogs, the same gene that causes deafness in some Dalmations also gives them blue eyes. But never before have we known about such a link in prostate cancer – and such an easy-to-notice one, at that.

Another Canadian study, and much smaller, but the results were equally outstanding. In this study, University of Toronto scientists have determined that early male pattern baldness represents a “strong and independent risk factor” for prostate cancer – and the more baldness, the higher the risk of cancer.

In the study, published in the Canadian Urological Association Journal, a research team looked at medical records and male pattern baldness in nearly 400 men who came to Princess Margaret Cancer Center in Toronto for prostate Biopsy. (This means that either they had a rising PSA or concerning findings from other tests, or a doctor had felt a suspicious area during a rectal exam.) They asked these men to self-report their “degree of baldness” at age 30; then, their hairlines were evaluated on the Norwood Scale, which classifies patterns of hair loss. Note: Self-reporting, scientifically speaking has room for error. Men might not have noticed exactly what was happening with their hairline; they may remember it as healthier than it actually was, or the opposite – there may have been some hair-loss denial happening.

However, the results were striking: The investigators found that men who had a greater extent of baldness – receding hair in the front, and a bald spot on top – had a higher risk of getting prostate cancer. Dr. Neil Fleisher, who co-authored the study, said men who develop baldness early and who get a lot of it “are particularly at risk.”

Men with a higher degree of baldness on the Norwood scale were three times as likely to be diagnosed with higher-grade prostate cancer, the kind that really needs to be treated.

Findings from both studies may soon mean that when men go to the doctor for regular check-ups, their doctor may take a picture of their hairline – and if the hairline starts to change, it may be time to start prostate cancer screening.

Yassa et al 2011 study published in the Annals of Oncology results also revealed that patients with prostate cancer were twice as likely to have androgenic alopecia at age 20. The pattern of hair loss was not a predictive factor for the development of cancer. There was no association between early-onset alopecia and an earlier diagnosis of prostate cancer or with the development of more aggressive tumors. This study shows an association between early-onset androgenic alopecia and the development of prostate cancer. In this study, a total of 669 subjects (388 with a history of prostate cancer and 281 without) were enrolled in this study. All subjects were asked to score their balding pattern at ages 20, 30 and 40. Statistical comparison was subsequently done between both groups of patients.

Another study in 2016 and published in the American Journal of Epidemiology followed a sample of 4,316 men, of which 107 deaths were attributable to prostate cancer, and did make links between specific types of hair loss and those who developed the disease.

The researchers explained that they found an increased risk of aggressive prostate cancer only in men with a very specific pattern of hair loss — baldness at the front and moderate hair-thinning on the crown of the head. Other types of hair loss patterns appeared unaffected.

Another study where the Researchers analyzed information from more than 4,000 U.S. men ages 25 to 74, who were assessed by a dermatologist and categorized has having no balding, or minimal, moderate or severe balding.Men with any degree of balding were 56 percent more likely to die from prostate cancer over a 21-year period, compared with men who were not losing their hair. What’s more, those with moderate balding were 83 percent more likely to die from prostate cancer, compared to those with no balding.The findings support the hypothesis that a shared biological process influences both balding and prostate cancer, the researchers said.

An earlier study found that men who start to bald in their 20s were at higher risk for prostate cancer than men who don’t start to lose their hair until later, but the new study found a link between balding and fatal prostate cancer regardless of age.

Interestingly, the new study did not find a link between severe balding and an increased risk of fatal prostate cancer. This could be because there were few men in the study with severe balding, which limited the ability of the study to detect a link, Zhou said. The study was presented at the American Association for Cancer Research meeting in Philadelphia.

Higher Risk of prostate cancer?

Currently, men known to be at higher risk for prostate cancer are:

Men with a family history of prostate cancer, and of other types of cancer.

Men of African descent.

Others are men who smoke and men who are overweight.

But currently judging from the current research, itappears like we need to increase this group to include men with frontal plus moderate vertex baldness. “Out of 143 forms of adult cancer,” says Simons, “prostate cancer is the only cancer where a hair feature that can be evident from across the room is associated with cancer risk. There’s nothing else in oncology like that kind of association.”

Important note on this research:

The researches focus on men who develop this baldness in their twenties and thirties. More studies are needed to figure out the specifics of when prostate cancer screening for these men needs to start, but it very well may need to begin when men are in their thirties. This is because the men with this pattern of baldness who do develop prostate cancer – and not all of them do, for reasons we don’t understand, perhaps involving such environmental factors as diet, weight, and exercise – have higher Gleason-grade cancer. So to young ones reading this pieceand losing your hair and you’re worried about prostate cancer, don’t despair. The hopeful news here is that you may have what so many scientists have been looking for – a clear sign, visible years before you might otherwise find out, that you might be at higher risk of prostate cancer. This means that you also have an excellent chance of having it detected in time to cure it before it ever becomes a problem.

The Norwood classification system classifies patterns of hair loss on a numeric scale.

0: no balding

1: frontal balding;

2: mild vertex balding

3: moderate vertex balding

4: severe vertex balding.

Take Away:

  1. It appears that male pattern baldness could be a strong independent risk factor for prostate cancer.
  2. But men with concerns should discuss with their physician about when and how frequently to undergo prostate cancer screening.
  • Male baldness may play a small role in estimating risk of prostate cancer
  1. Young men in their twenties and thirties with baldness are at higher risk of prostate cancer
  2. These young men should start employing modifiable life styles changes to reduce their risk of prostate cancer as they are already in a high risk group.
  3. There is an Increased risk of aggressive prostate cancer only in men with a very specific pattern of hair loss — baldness at the front and moderate hair-thinning on the crown of the head. Other types of hair loss patterns appeared unaffected.
  • Up to 20% of men in their twenties will have male pattern baldness, with the rate increasing among men with each decade of life

Dr. Raphael NyarkoteyObu is a research Professor of Prostate cancer and Alternative Medicine at Da Vinci College of Holistic Medicine, Larnaca city, Cyprus. He is the National President of Alternative Medical Association of Ghana (AMAG) and a registered Holistic Medical Practitioner focusing on Naturopathic Urology-a Member of the Prostate Cancer Transatlantic Consortium (CaPTC) researching into Prostate cancer in West African Men enquiries 0541090045


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