Testosterone and Prostate Cancer: What You Need to Know
There’s a myth afoot – that there’s a link between testosterone and prostate cancer. We’re here to dispel that. Here’s what you need to get the help you need.
Got testosterone and prostate cancer on the mind?
Is it because you suffer from low testosterone (Low T)? Or, because you suspect you might? Youโve noticed that youโre gaining weight around your midsection, feeling fatigued much of the time, and having trouble performing sexually. And, you know those are some ofย the symptoms.
Do you worry about how testosterone replacement therapy might be increasing your risk of prostate cancer? Maybe the risk has stopped you from trying the therapy altogether.
Well, youโre not alone. And youโve come to the right place.
There’s a myth afoot โ that testosterone therapy increases your risk of prostate cancer.ย We’re hereย to dispel that. Here’s what you need to know to get the help you need.
Testosterone and prostate cancer
First, you donโt need to accept your Low T condition as your new normal.
And, you donโt need to worry about invitingย prostate cancerย when you undergo testosterone replacement therapy either.
Plus, a new study even suggests that testosterone therapy reduces the chance of aggressive prostate cancer in men.
Weโre counting. And thatโs a win, win, win.
Seems too good to be true?
Stay with us.
How did testosterone therapy get a bad name?
There are two old studies to know about.
First, in 1941,ย Huggins and Hodges published a studyย of three men with metastatic prostate cancer, who were given testosterone therapy after theyโd already been diagnosed. (Thatโs right, theyโd already been diagnosed and cancer had already spread to other parts of their bodies.)
Only one man’s cancer progressed during therapyย (based on a lab test not used anymore). From this, Huggins concluded that testosterone therapy could increase theย growth of prostate cancer in metastatic disease. Thereโs nothing wrong with his conclusion.
But, unfortunately, itโs been interpreted incorrectly over these years.
Somehow it came to be that testosterone caused prostate cancer, even as smaller studies proved it did not.
Itโs important to note that this same man had been castrated before therapy. Because castration was known to decrease prostate cancer. Probably this idea that removing testosterone could shrink prostate cancer helped support the misunderstanding of Hugginโs conclusion โ that testosterone caused prostate cancer.
Later, in 1981, Fowler and Whitmore of Sloan-Kettering Memorial Hospitalย published their studyย of 52 men who also already had metastatic prostate cancer prior to therapy. 45 of the men responded poorly to the therapy. 48 men had been castrated previously, too.
Whatโs all this talk of previous castration?
When a man is castrated his testosterone level drops to zero, or pretty close to zero.
And, when you later reintroduce testosterone to his system, his prostate gland fuels prostate growth โ thatโs known as testosterone flare.
If you add testosterone to a man who already has a certain threshold of testosterone in his body, though, (a man who hasnโt been castrated, in other words), there wonโt be further prostate growth.
This is the saturation model, asย discovered by Marks and colleaguesย in 2006ย and coined by Morgentaler later on. Testosterone works when there are receptors available to carry it into the cell. The receptors in the prostate gland, it turns out, are saturated at fairly low levels of testosterone.
So testosterone only causes prostate growth up to a certain threshold, and itโs a pretty low threshold. The sort of threshold youโd want to consider therapy for (according to a new study), before prostate cancer develops (by some other set of factors, and not because of the therapy itself), and hopefully to avoid cancer altogether.
What doesย the new studyย say?
NYU Langone Medical Center and its Laura and Issac Perlmutter Cancer Center analyzed more than a quarter million medical records of mostly white men in Sweden โ one of the very few countries that keeps detailed records of cancer and prescription medicine for its whole population. There isnโt a North American data set thatโs equivalent.
They found that, as a group, men prescribed testosterone for longer than a year did not experience an increased risk of prostate cancer. And, in fact, that their chance for aggressive prostate cancer reduced by 50%.
Stacy Loeb, MD, an NYU Langone urologist and the lead on this study, still advises physicians to look for prostate cancer risks in men taking therapy. Patients over forty, patients with a family history of the disease, and patients of African-American descent are considered to be at greater risk, in any case, as some examples. But, she also stresses that physicians should not shy away from prescribing therapy to appropriate patients for fear that the therapy itself will create aย greater risk of disease.
Loeb says that overall itโs best for men to maintain balanced testosterone levels. If your numbers fall below 350 nanograms per deciliter, you should seek medical advice to see if you should undergo therapy.
Because, all other factors being the same, facing any eventual prostate cancer with balanced testosterone levels seems favorable to facing it with lower testosterone levels.
Thatโs right. Testosterone can actually lower the risk of prostate cancer, and help you through it if it comes.
This is big news…
Because testosterone treatments are already common.
In the last decade, surveys tell us thatย testosterone therapy has skyrocketed among middle-aged men. And this even in the face of some uncertainty about increasing risk of prostate cancer.
And because prostate cancer is a leading cause of death for men.
One in seven men develop prostate cancer.ย Thatโs a higher percentage than the number of women who develop breast cancer.
And because most men become testosterone deficient.
Indeed, testosterone levels naturally drop by about 1% per year once a manย reaches hisย thirties. If your testosterone drops at this rate, you likely wonโt experience clinically low testosterone until youโre in your 80s. But many men experience clinically low testosterone before then, and theyโre chiefly whom this new study is hoping to serve.
Really, when you think about it…
The idea that testosterone therapy increases theย risk of prostate cancer never made much sense. Because prostate cancer is only common in older and middle-aged men with naturally declining testosterone levels. It typically strikes in men over
Because prostate cancer is only common in older and middle-aged men with naturally declining testosterone levels. It typically strikes in men over 65ย and is quite uncommon in men before age 40. It almost never affects men with the highest testosterone levels โ teenagers and 20 somethings.
So, next upโฆ
Loeb says her team will seek to learn why lower testosterone levels seem to trigger aggressive prostate disease, and why maintaining normal testosterone levels through therapy seems to keep aggressive disease away.
And right now…
Testosterone treatment is not a pact with the Devil. Itโs not trading short-term sexual energy for long-term malignant cancer. Nope, testosterone and prostate cancer aren’t mortal enemies.
So, more than ever, we want to help youย overcome your Low T, safely and smartly.
Still thinking about it?
Donโt.
If you suffer from Low T, or think you might, itโs a medical imperative that you check your numbers โ and get your balance back, if you need to.
Hereโsย what to expectย at your consultation, and hereโsย what our community has to say about working with us. Check out ourย FAQs, and download our e-book for even more information.
Weโre here, and weโll always be here.
Because thereโs too much life youโre missing out on with Low T. You can look better, feel better, and be the man you and your loved ones deserve โ for longer.