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Testosterone replacement therapy and prostate risks: where's the beef?
1Division of Urology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
The Canadian Journal of Urology
|March 11, 2006
Summary
Conventional medical wisdom suggests higher testosterone increases prostate cancer risk. However, studies show no increased risk, even in hypogonadal men receiving testosterone therapy.
Area of Science:
- Endocrinology
- Urology
- Oncology
Background:
- Conventional medical wisdom for 60 years posits that higher testosterone levels increase prostate cancer risk.
- This belief stems from prostate cancer regression observed with castration.
- However, robust scientific data supporting this link is lacking.
Purpose of the Study:
- To evaluate the association between testosterone levels and prostate cancer risk.
- To critically examine the evidence linking testosterone supplementation to prostate cancer development.
Main Methods:
- Review of clinical trials involving testosterone supplementation.
- Analysis of longitudinal population-based studies.
- Examination of data from hypogonadal men undergoing testosterone treatment.
Main Results:
- No increased risk of prostate cancer was observed in clinical trials of testosterone supplementation.
- Longitudinal studies and high-risk hypogonadal populations showed no correlation between higher testosterone and increased prostate cancer risk.
- Hypogonadal men exhibit significant rates of biopsy-detectable prostate cancer, indicating low testosterone is not protective.
Conclusions:
- Current scientific data do not support the long-held belief that higher testosterone levels increase prostate cancer risk.
- Testosterone replacement therapy does not appear to elevate the risk of developing prostate cancer.
- Low testosterone levels do not confer protection against prostate cancer development.