Testosterone Replacement: Good or Bad for Prostate Cancer Patients?
Testosterone replacement therapy may be both safe and sound for some men after prostate cancer removal.
This finding, summarized in The ASCO Post, flies against some current practices. It adds needed data, however, to similar results from past, smaller studies, says Nicholas Hauser, M.D., urology expert with Sylvester Comprehensive Cancer Center, part of the University of Miami Health System.
“This research was focused on seeing if men with low testosterone levels had a higher risk for prostate cancer if they took a testosterone supplement,” he says. “Researchers were looking at past data from Veterans Affairs health records.”
The research team found that among a set of men who had already had a low-grade prostate cancer removed, those who had testosterone replacement therapy afterward did not have cancer return as quickly as similar men who did not have testosterone replacement therapy. On the contrary, prostate cancer returned at a slower rate.
Does it mean testosterone is suddenly safe for men with non-aggressive prostate cancer or after the removal of the cancer? Not quite, says Dr. Hauser.
More research is still needed
“This study of 834 men was the largest study to date of this subject,” he says. “It adds to a growing literature base of similar studies. However, we need to be careful, because this research did not set out to look at the variables involved.”
Dr. Hauser adds that the study only looked at results three years following surgery. In most cases, five to 40 percent of men who have their prostate removed will experience cancer returning at a later date.
Treatment guidelines currently call for an individualized approach and plan based on each patient’s cancer and other health conditions, he says.
Men with low-grade prostate cancer have four main options for therapy:
- Routine monitoring
- External beam radiation therapy
- Brachytherapy (small radioactive “seeds” implanted in the prostate gland)
“We take each man’s treatment case by case,” says Dr. Hauser. “We sometimes prescribe testosterone replacement therapy for men with low-risk of cancer returning, but we do not use a universal approach. This additional data will lead to further studies, all focused on helping the greatest number of men to avoid prostate cancer, and to fend off or delay a recurrence.”
John Senall is a contributing writer for UMiami Health News. He is a former hospital and comprehensive cancer center communications director.