In the last 30 years, doctors have told millions of men worldwide that they have low testosterone levels and have given Testosterone therapy as a treatment. At the same time, oncologists have confirmed that testosterone is a factor that causes prostate cancer and have treated the disease by lowering patients’ levels of testosterone.
No Risk of Aggressive Prostate Cancer
With this in mind, research shows that treatment with testosterone did not raise the risk of aggressive prostate cancer in nearly 150,000 men over age 40 with low testosterone levels.
Thomas Walsh, Alvin Matsumoto, and Molly Shores of UW Medicine and the VA Puget Sound Health Care System in Seattle led the study published in the journal PLOS ONE.
Walsh, an associate professor of urology at the University of Washington School of Medicine and a clinician at VA Puget Sound, said, “This finding doesn’t change how we recommend testosterone therapy.” “Men should still have their testosterone levels checked multiple times and be advised about the risks and benefits of treatment. But this large body of evidence lets us look patients in the eye and say, “Testosterone therapy does not seem to increase the risk of prostate cancer over a moderate time period.”
What is Testosterone?
Testosterone is a hormone made in men’s testicles. It helps men get stronger and keep their bones healthy. Its level naturally goes down as time goes on. The American Urological Association says that about 2% of adult men have a level of testosterone that is too low. Low-T, as it is often called, can cause tiredness, less muscle mass, irritability, and a low sexual drive.
Researchers looked at the health records of 147,593 men diagnosed with low testosterone between 2002 and 2011. Within six months of being told they had prostate cancer, all of the men had normal results for PSA, which is the main sign of prostate cancer. 58,617 people in this group got testosterone therapy. The average length of time that patients were watched was three years.
Looked at How Aggressive Prostate Cancer Grows.
“We now know that the nonaggressive variations can be followed over time and may not cause significant increases in morbidity or mortality. So, for the study, he said, “we thought it was more important to find the high-risk prostate cancers, which have a very high PSA or are known to spread based on their histology.”
The study found that aggressive prostate cancer was diagnosed in 0.58 out of every 1,000 person-years among men who had testosterone therapy. It was 0.57 per 1,000 person-years. The rate was almost the same for men who hadn’t been treated (n = 88,976).
Walsh said that the VA’s closed medical and pharmacy system was a significant strength of the study for three reasons:
It made it less likely that the people in the study got good care outside of the system.
Researchers could better control for other serious illnesses that affected the death rate of the study population because the patients’ data sets included complete medical histories.
Most People Never Reach a Biologically Therapeutic Level
Most people who got testosterone therapy got it through an injection into the muscle. This was the most common way to give testosterone therapy during the study and was also the most bioavailable. “Many studies have shown that when men get testosterone through a cream or patch, they never reach a biologically therapeutic level. Most of the men in our study got injections, and tests afterward showed that their testosterone levels went up because of the therapy,” Walsh said.
In the United States, the number of testosterone prescriptions has increased significantly over the past ten years. This is partly because the population is getting older and partly because drug companies are marketing to older men. Clinical guidelines say that prescriptions are appropriate for men who have been found to have low testosterone more than once and have specific symptoms. However, Walsh said that it is becoming more common for doctors to give testosterone to a patient with only one finding of low testosterone and vague symptoms.
Walsh said, “We know that most of these men are treated for short periods of time.” basically, less than a year.