Testosterone therapy should be reevaluated as a treatment option for men with low-risk and untreated prostate cancer, according to a study published in the April edition of The Journal of Urology.
“Generations of medical students and residents were taught that providing testosterone to a man with prostate cancer was like pouring gasoline on a fire,” said researcher Dr. Abraham Morgentaler at Men’s Health Boston, according to a Beth Israel Deaconess Medical Center press release.
“For many decades it had been believed that a history of prostate cancer, even if treated and cured, was an absolute contraindication to testosterone therapy, due to the belief that testosterone activated prostate cancer growth, and could potentially cause dormant cancer cells to grow rapidly.”
The basis for this belief is that prostate specific antigen (PSA) levels decrease when testosterone levels are decreased using female hormone therapy, and PSA levels are routinely used as an indicator in diagnosing and monitoring prostate cancer.
In the small study, 13 men with untreated prostate cancer received testosterone therapy for between approximately one and eight years. The men were originally diagnosed with low to moderately aggressive prostate cancer based on the Gleason score.
The size of the prostate and their average prostate specific antigen (PSA) levels did not change with testosterone therapy, and the researchers concluded there was no cancer progression in the short to medium term, consistent with the saturation model in which cancer is believed to proliferate when testosterone levels are low.
Morgentaler said the men in the study were rigorously followed, and had typical forms of prostate cancer as seen in men who have received invasive surgical or radiation treatment. “Clearly, the traditional belief that higher testosterone necessarily leads to rapid prostate cancer growth is incorrect,” he added.
Additionally, testosterone therapy has various beneficial effects such as improvement in fatigue, libido, and sexual function, according to the press release. It may also improve other factors such as mood, blood sugar control, muscle mass, bone density, and possibly even longevity.
“An increasing number of newly diagnosed men with prostate cancer opting for active surveillance, and with many of them also desiring treatment for their signs and symptoms of testosterone deficiency, the results suggest a reevaluation of the long standing prohibition against offering testosterone therapy to men with prostate cancer,” Morgentaler said.
