Early balding linked to prostate cancer: Study

By Dr. Ananya Mandal, MDFeb 16 2011

Balding early in life causes grief for many men and now new research will cause even more alarm. Researchers have found that early balding may be liked to prostate cancer.

The research team led by Dr. Pierre Giraud at the Paris Descartes University in Paris studied 669 men and noted that men who showed signs of hair loss in their 20s were twice as likely to develop prostate cancer decades later compared with men who did not show evidence of balding until their 30s. The study was published Tuesday in the Annals of Oncology.

Earlier evidence in this regard has been confusing. Several trials found a similar positive relationship between early male pattern baldness and cancer incidence, while one found a decreased risk of prostate cancer among those with early hair loss. This trial looked at men with and without a history of prostate cancer, and then asked about whether and when they experienced any balding. They found that the type of hair loss did not matter. Men with both receding hairlines as well as balding at the crown during their 20s had the same heightened risk of cancer.

The exact mechanism of this association is still not known. Experts suspect that the male hormones known as androgens may play a critical role in promoting both conditions. Androgens, which include testosterone, can inhibit hair growth while triggering abnormal expansion of prostate cells. Another support to this this theory is that the drug finasteride, or Propecia, which blocks the effects of androgens, works to both retard hair loss and control growth of prostate tumors.

According to co-author Dr. Michael Yassa, a radiation cancer specialist at Maisonneuve-Rosemont Hospital and the University of Montreal, the results suggest that it may be possible to screen for prostate cancer before the tumors become problematic. Most prostate cancers grow slowly over a period of years. This association could serve as a screening method for susceptible men he said. Yassa said, “Now, we talk about maybe screening those at high risk for prostate cancer…Family history of a risk factor, and we know African Americans tend to develop more prostate cancer. But that is pretty much it. Maybe balding is one, so we think this is an area where we should do further research to identify those who might benefit from screening.”

However researchers add that all bald men should not be alarmed. Yassa notes that more research is needed to understand whether different types of hair loss, receding hair lines as opposed to shedding at the crown, are more or less connected to cancer. About one in four men with male pattern baldness starts to lose his hair before age of 21 and two out of three will experience some hair thinning by age 35, according to the American Hair Loss Association.

American Cancer Society Director of Prostate and Colorectal Cancers Durado D. Brooks and American Cancer Society Chief Medical Officer Otis Brawley suggest that the evidence is still at the stage of “speculation” and “There is no reason for bald men to obsess about this.” The American Cancer Society recommends all men at age 40 have a baseline PSA screening as well as a digital rectal exam and then starting at the age of 50, annual screenings and exams. As of now, these recommendations stand.