Testosterone treatment in men with a history of prostate cancer is still controversial as there are no large studies to assess the safety of this therapy in such cases. Research studies indicate that men should avoid testosterone replacement not only in cases where there is a history of prostate cancer, but also even if there is a suspicion of prostate cancer. However, urologists are now looking into the benefits of testosterone replacement in these situations.
Recently scientific myth (doctrine based on a poor study) inferred that therapy with testosterone was potentially harmful because higher levels of this hormone in the blood would lead to a more rapid growth of cancerous cells of the prostate. The underlying concept is that any cancer cells that may exist in the prostate may be stimulated by testosterone to grow. However it should be noted that these studies were conducted over 50 years ago with a small number of men in the study and in men who had been castrated. In the past, castration was the only procedure used to control prostate cancer. Nowadays, the prostate is often removed and or followed by chemotherapy and radiation.
Some modern research studies are now showing different results. Recent findings indicate that in both humans and animals there is no effect on prostate cancer growth if there are significant changes in testosterone levels (as would happen if it would be given therapeutically). In addition, case studies collected by urologists show a clear benefit of using testosterone in patients with a history of prostate cancer who experience symptoms of low testosterone levels such as fatigue and low sex drive. Testosterone replacement also reduced the body fat and increased the lean muscles in addition to improving the libido and energy levels.
At the 2012 American Society for Radiation Oncology’s 54th Annual Meeting, researchers from Fox Chase Cancer Center brought scientific evidence that men whose testosterone levels drop as a result of radiation therapy (for prostate cancer) are more likely to experience an increase in PSA levels (prostate specific antigen) which translates into an increased risk of prostate cancer recurrence. This conclusion is based on the study of over 250 men who received two types of radiation therapy, brachytherapy or intensity modulated radiation therapy (IMRT).
Only recently research studies demonstrate the safety of using testosterone in patients with a history of prostate cancer. Urologists have the duty to inform the patients that there is an “unknown degree of risk” of cancer recurrence, although the data collected so far is very reassuring. The therapy with testosterone is easy to follow with a variety of forms now being available (gel, patches, long acting injections, subcutaneous implants). Testosterone replacement is also easy to monitor with simple blood tests to determine levels. The decision to use this therapy should only be taken after a physician evaluation. The physician will explain the benefits and risks of using testosterone replacement in your specific case.