Male alopecia (hair loss) may increase risk of prostate cancer. Wait – hair loss might also protect you from this common male cancer. Confused yet? So are researchers, who’ve studied the link between alopecia and prostate cancer with mixed results to show for their efforts.
The most recent date suggests the former, that hair loss really does increase the odds a man will develop aggressive prostate cancer. But we don’t know why, and this contradicts a 2010 study which found men with alopecia before 30 were at lower risk of this common health threat.
About the only thing we know for sure is the link exists. Testosterone is responsible for the vast majority of male pattern baldness and plays a role in prostate cancer too. The takeaway message here is that early alopecia might warrant a conversation with your doctor, though its role in prostate cancer screening is unclear.
Alopecia Might Increase Risk of Prostate Cancer
A study published in September 2014 found that men with male pattern baldness might be at higher risk of prostate cancer than men with no hair loss. This form of alopecia typically starts at the hairline and crown (upper back) of the head. It’s the result of life-long exposure to testosterone in the skin.
Guys with this common form of alopecia tend to have high levels of free testosterone and sensitivity to it, which causes DHT to destroy follicles, causing baldness.
The study consisted of roughly 40,000 American men between 1993-2001. Each man was between 55 and 74 and answered questions about the level and type of hair loss he had at 45. About 18% of the men remembered balding at that age, say the researchers.
The American Cancer Society recommends men speak with their health care provider starting at 50 if they’re at moderate risk of prostate cancer.
More than 1,100 of the men were diagnosed with prostate cancer when researchers followed up with them between 2006 and 2008. Six hundred of them had an aggressive form of prostate cancer. And men who specifically reported male pattern baldness – at the crown and hairline – were 39% more likely to have aggressive prostate cancer than men with no alopecia.
But the link only applied to aggressive prostate cancer. Balding men were not more likely to have less severe forms of the disease.
The study had some major limitations. It relied only on memory of hair loss, for example, to determine each man’s hair loss levels at 45. They might not have accurately remembered this. Eighty-nine percent of the men were white too, so it fails to answer how non-white men would be affected. And even if hair loss becomes a condition to monitor for prostate risk in the future, it’s just one of many factors that might increase that risk.
Or Does It?
So far we’ve confirmed there’s a link between men with alopecia and risk of prostate cancer. But here’s where it gets interesting. Another study – this one published online in the journal Cancer Epidemiology – found men were at lower risk of prostate cancer if they lost hair before 30.
The longer each man in this study had alopecia, the lower his risk of the disease.
This study consisted of 999 men between 35 and 74. Each man had been diagnosed with prostate cancer between 2002 and 2005 in King County, Washington. Researchers compared the mens’ health records to those of 942 men without prostate cancer of the same age. All men reported their hair loss patterns at 30, be there none, a little, moderate or more advanced alopecia.
The men with prostate cancer also reported their hair loss, if any, a year before diagnosis. Men without the disease did the same a year before a reference date that corresponded with the dates at which the prostate patients were diagnosed.
Each man reported if he’d used drugs that could influence male hormones, which could skew the study findings.
On the study’s conclusion, the researchers found men with the most significant hair loss by 30 had a 29% lower risk of prostate cancer. The team broke this group down further into a subgroup of men with traditional male pattern balding – at the hairline and crown – and men over 60 at the reference date.
Men in this smaller subgroup had even more protection from prostate cancer, according to the study results, with a 45% lower risk of the disease compared to the 29% lower risk that men with less severe hair loss experienced.
The findings suggest there’s more going on here than we’d previously thought. Much evidence, including the study released last month, suggest early balding leads to higher risk of prostate cancer. So why the discrepancy? We don’t know, but some experts point to genetic differences among balding men.
A genetic variation in the male hormone receptor gene can affect both alopecia and cancer development, for example. Genes could be working in other ways too, perhaps in the scalp and prostate. Or some men might just have more DHT in their scalp than prostate. More studies are needed to better understanding this health issue that affects at least one man in every seven.
Prostate Cancer Screening: A Hot Topic
Prostate cancer is not always fatal. Indeed, the survival rate at 10 years hovers in the 90% range, and most men with prostate cancer die of other causes than the disease. Screening for prostate cancer aims to make that possible, but it’s a controversial topic because some experts claim it does more harm than good.
Of course, you’re concerned about your health, and prostate cancer should be on your radar regardless of hair loss. The American Cancer Society recommends men speak with their health care provider starting at 50 if they’re at moderate risk of prostate cancer. Men at high risk – that’s African-Americans or with a father, brother or son diagnosed with prostate cancer before 65 should have that conversation starting at 45.
We don’t know enough about the link between hair loss and prostate cancer to say if that puts men at higher (or lower) risk of developing the disease. That might change in the future.
We don’t know enough about the link between hair loss and prostate cancer to say if that puts men at higher (or lower) risk of developing the disease. That might change in the future.
Men at highest risk – that’s men with more than one first-degree relative with prostate cancer before 65 – should have that talk beginning at 40.
Your doctor should guide you through this process and will likely recommend a prostate specific antigen (PSA) test and possibly a digital rectal exam. A Canadian task force recently countered that the PSA test often leads to false-positive results and overdiagnosis. That may lead to more, often unneccessary tests like biopsy, which can lead to bleeding, infection and urinary incontinence.
Also, we don’t know if PSA testing reduces mortality. It might, but like the hair loss and higher risk factor, we don’t know yet – and that’s all the more reason to have an open dialogue with your health service provider.
The Takeaway Message
Prostate cancer is the most commonly diagnosed non-skin cancer in men. Roughly 233,000 new cases are diagnosed each year in the United States, and with almost 30,000 men who succumb to it annually.
The average age of diagnosis, according to the American Cancer Society, is about 66.
While we’ve yet to define the relationship between alopecia and prostate cancer, you can’t go wrong by at least watching out for prostate cancer symptoms. Speak with your physician about it – especially if it’s been an issue for men in your family before 65. Watch for further research in the link between alopecia and risk of prostate cancer, be it higher or lower. Then, after that, move on to other things.
