Movember is a great opportunity for people to learn about important men’s health issues. As a urologist who specializes in the diagnosis and treatment of testosterone deficiency, I wanted to present some facts regarding the relationship between prostate cancer and testosterone. My hope is that a few concrete pieces of information will help men understand this complex relationship so that they can make educated decisions about their healthcare.
FACTS
- The prostate gland requires testosterone for NORMAL development.
- Testosterone deficiency (“low T”) is a medical condition that warrants treatment in properly diagnosed individuals.
- Contrary to popular belief, low testosterone levels may actually INCREASE the risk of developing prostate cancer.
- Men with low testosterone may also be at risk for the development of more AGGRESSIVE prostate malignancy.
- Patients diagnosed with low testosterone MUST be screened for prostate cancer through prostate examination and PSA blood testing.
- PSA results can be more difficult to interpret in the face of low testosterone levels making it imperative that men seek out a urologist with experience in doing so.
- Men suspected of having prostate cancer MUST undergo a prostate biopsy before starting testosterone replacement therapy.
- Men on testosterone therapy MUST be monitored carefully for prostate cancer and therapy should be STOPPED if cancer is suspected.
- Patients with a history of prostate cancer are often told by doctors that testosterone therapy is “ABSOLULTEY FORBIDDEN”.
- Once prostate cancer is diagnosed and treated SUCCESSFULLY, testosterone therapy CAN BE safely prescribed by an expert.
FICTION
- Testosterone CAUSES prostate cancer.
- Testosterone therapy will INCREASE a man’s risk for developing prostate cancer.
- Men on testosterone replacement therapy do NOT require monitoring for prostate cancer.
- Prostate cancer that develops while using testosterone will be VERY aggressive.
- Men with prostate cancer can NEVER receive testosterone therapy.
Summarizing, testosterone therapy is safe for the prostate when administered by experts. Men with testosterone deficiency must be screened for prostate cancer before starting testosterone replacement therapy (TRT). Men treated with TRT must be monitored for prostate cancer using prostate exams and PSA testing on a regular basis. PSA results must be interpreted with caution and expertise because subtle changes may indicate cancer. Men who develop prostate cancer while on testosterone therapy must be recognized early so that treatment can be stopped. Once the cancer is successfully treated, many men can safely resume testosterone replacement therapy if they are monitored by an expert.
