What is it about?

To determine the effect of opioid consumption on the serum prostate-specific antigen (PSA) level.

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Why is it important?

Opioids are present in the prostate gland, and in vitro studies have shown that opioid agonists interfere with PSA secretion and decrease the proliferation of prostate cancer cell lines. PSA expression is dramatically influenced by androgens, and an in vitro study has shown that opioids inhibit androgen-induced PSA secretion. In addition to the direct effects on prostatic tissue, opioids have been hypothesized to affect the hypothalamuspituitary-gonadal axis and suppress androgen production. Consequent hypogonadotropic hypogonadism could also alter the serum PSA level. The effect of opioids on the serum PSA level has never been tested in vivo.


Opium consumption was associated with a significant decline in the serum PSA level. The prevalence of androgen deficiency was greater among opium users. However; a decreased PSA level did not seem to be related to androgen deficiency in opium users, because both eugonadal and hypogonadal opium users had lower serum PSA levels than the corresponding control subjects. Although opioids might interfere with cell growth and reduce the risk of prostate cancer, the antiproliferative role of opioids has remained unclear, and performing biopsy at lower PSA cutpoints in opioid users is a reasonable option.

Dr Mohammad Reza Safarinejad
University of Medical Sceices

Read the Original

This page is a summary of: Influence of Opioid Consumption on Serum Prostate-specific Antigen Levels in Men Without Clinical Evidence of Prostate Cancer, Urology, July 2012, Elsevier,
DOI: 10.1016/j.urology.2012.04.006.
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