Does Testosterone Replacement Therapy (TRT) Cause Higher Prostate Risk? – What Does The Science Say?

Sixty can be a significant number in any sense of the word. Whether we are talking about 60 days, 60 months, 60 children, 60 employees or even 60 years. Furthermore, it is an eternity when we are talking about medical and other scientific breakthroughs from yesterday, not being thoroughly challenged sooner than this timeframe. This is exactly what has occurred when famed Dr. Charles B. Huggins, a urologist at the University of Chicago, made a connection in 1966 presenting that the presence of testosterone and growths in prostate cancer were related. This discovery at this time indeed was a scientific marvel; he even won a Noble Prize for his efforts. Little did he know that this link he found would forever change people’s view of testosterone as it relates to potential prostate risks. Sadly, no other medical professional, at least on record, questioned Huggins’ conclusions until recently. With today’s scientific studies and new findings of testosterone and prostate cancer risks, millions of men between the ages of 30-79 are turning to TRT (testosterone replacement therapy) to help restore their diminished testosterone. A large number of these men have regained a part of their life they used to enjoy and now with more peace of mind than ever.

What Is TRT?

TRT or Testosterone Replacement Therapy is a medical treatment alternative prescribed and administered by physicians. This treatment is usually for aging men with very low testosterone levels. If a patient has the right mindset, and is ready to put in some effort on their end, the results of professionally monitored TRT treatments have significantly shown the ability to restore a positive sense of “self.” In addition, TRT can also make a man feel rejuvenated with a heightened sense of well-being, not experienced in years for the patient. Moreover, there are many well-documented accounts of TRT improving:

    • Libido
    • Erectile Dysfunction
    • Mood
    • Cognition
    • Lean Body Mass
    • Bone Density

The Argument

It is wide accepted that prostate cancer is heavily androgen-dependent. This means that the cancerous prostate cells depend on androgens to spread and depend on it for regulation. Androgens are crucial to maintaining growth and to the existence of the cancerous cells. When androgen, in the form of testosterone, is suppressed, the cancer regresses, and the cells begin to die out. Even today, the pharmacological decreasing of the serum T to castrate levels is a standard treatment complex prostate cancer. However, if medically lowering T levels can make prostate cancer die out, then the same logic has to be applied to the process of medically increasing T levels, right? This is the basis of Huggins’ findings, saying that the more testosterone is added, the higher chance of prostate cancer and growths.

Clinical trials with TRT   

Do today’s clinical trials give us any hard data in regards to the potential risk of prostate cancer among men between the ages of 30-79 who are currently receiving TRT? On a large scale, there have not been long-term controlled trials performed. However, there was a short-termed TRT trial conducted that drastically helps shed some light on this topic in favor of TRT as a safe alternative for the hypogonadism male. In 2004, a review of trails for TRT was conducted and lasted between six and 36 months. What the trials discovered was that the “cancer detection” rate, was only 1%. With retrospective and shorter studies, the same rates arrived. Cancer detection in men who are undergoing prostate screening has seen very similar results around 1% as well.

Conclusion

Even though many attempts have been made to relate unequivocally, higher T levels to higher risks of prostate cancer, there still is no sound evidence to support this hypothesis.

As doctors, this should be thoroughly taken into account and TRT revisited as a safe and sound treatment for the hypogonadal man. When analyzing risks versus benefits, we must look at the person as a whole and make evaluations this way. In conclusion to all the results laid out here, professionally monitored TRT treatments by a licensed doctor can be an extremely useful treatment for the hypogonadal man looking to fully enjoy his life to its fullest potential.

 

References:

Testosterone Replacement Therapy and Prostate Risks: Where’s the Beef?

Abraham Morgentaler, MD Division of Urology Beth Israel Deaconess Medical Center Harvard Medical School Boston, Massachusetts, USA

Link: Testosterone Replacement Therapy and Prostate Risks: Where’s the Beef?

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