Testosterone Replacement Therapy for men has begun picking up steam in the last few years. Testosterone is the major male sex hormone that is responsible for the development of male secondary sex characteristics. This includes the development of reproductive structures such as the penis, scrotum, and testes. The increase in testosterone at puberty also plays a role in the development of the prostate gland. With the increase in male hormones, the prostate gland increases in volume during puberty.

Because of this association, it was thought for years that testosterone could be one of the factors in the development of prostate cancer. This has scared off many men interested in TRT. This also became a heated debate among medical providers. In 2015, however, the review paper titled “Testosterone and prostate cancer: an evidence-based review of pathogenesis and oncologic risk” by Michaud et al cleared up much of the confusion. The paper outlines various scientific studies discussing the link between testosterone and prostate cancer, and whether testosterone replacement therapy (TRT) causes increased prostate risk (1). Let us take a quick look at the important points presented by the review paper.

The influence of testosterone on the development of prostate cancer is still debated in the scientific community. Michaud et al. however debunks this myth by outlining various studies that have shown that increased prostate cancer risk is associated with decreased testosterone levels. For instance, a study conducted in Korea showed that men who had undergone biopsy for prostate cancer had low testosterone levels (below the median level of 13.3 nmol/L) (2).

More recent data has also, showed that there is no association between testosterone and prostate cancer risk. Michaud et al. cited the Reduction by Dutasteride of Prostate Cancer Events (REDUCE) trial, conducted in 2012. The reduce trial showed that among 3242 patients (50–75 years old) in the placebo arm of the trial, there was no identified association between testosterone and prostate cancer risk or grade (3).

The effect of testosterone on prostate cancer development is a relevant topic for patients who receive Testosterone Replacement Therapy (TRT) for hypogonadism, a condition defined by decreased androgens and is manifested by decreased energy, muscle mass, and erectile dysfunction (1). The findings of the REDUCE trial indicating that testosterone levels do not really influence the development of prostate cancer is definitely positive and reassuring for men who are receiving TRT. Furthermore, Michaud et al. also shares that studies were not able to show a significant increase in prostate cancer progression among patients who are TRT. However, large studies on the definitive effects of TRT on prostate cancer are still lacking.

While there are scientific studies that show that TRT is likely safe and does not carry any risk for prostate cancer, we should keep in mind that TRT among prostate cancer patients are still considered as experimental. Healthcare professionals and patients should, therefore, discuss thoroughly whether the patient is a suitable candidate for TRT, considering the risk of prostate cancer.

Seeking a men’s health clinic in Toronto? If you are looking for a TRT Therapy in Toronto contact Arv Buttar (Nurse Practitioner) at info@healthbyarv.com.

Arv Buttar is a Family Nurse Practitioner with a specialty in Testosterone Replacement Therapy in Toronto. Her Clinic is located in downtown Toronto. It is easily accessible to the surrounding GTA (Brampton, Mississauga, Burlington, Oakville, Etobicoke, North York, Richmond Hill, Milton, Markham, Barrie, Newmarket, Scarborough).

References:

1. Testosterone and prostate cancer: an evidence-based review of pathogenesis and oncologic risk. Michaud, J., Billups, K., and Partin, A. 6, 2015, Ther Adv Urol, Vol. 7, pp. 378–387.

2. Is decreased serum testosterone level a risk factor for prostate cancer? A cohort study of Korean men. Shin, B., et al. 2010, Korean J Urol, Vol. 51, pp. 819–823.

3. Serum testosterone and dihydrotestosterone and prostate cancer risk in the placebo arm of the reduction by dutasteride of prostate cancer events trial. Muller, R., et al. 2012, Eur Urol, Vol. 62, pp. 757–764.